Thank you, Mary Ann. Sounds like we are finally getting somewhere. William E. Haik, M.D., F.C.C.P., C.D.I.P. AHIMA Approved ICD-10-CM/PCS Trainer Office: (850) 863-2110 Cell: (850) 803-5854 Fax: (850) 864-4438
> On Jan 21, 2015, at 5:53 AM, Barnes-Daly, Mary Ann > <[email protected]> wrote: > > At the SCCM congress on Monday it was revealed that new criteria for the > screening and dx of sepsis were to be released in October. The somewhat > arbitrary use of SIRS criteria will be replaced with indicators that have > been identified by a retrospective analysis of large databases - "the new 3". > Stay tuned. > > Sent from my Android phone using TouchDown (www.nitrodesk.com) > > -----Original Message----- > From: William Haik [[email protected]] > Received: Wednesday, 21 Jan 2015, 1:10AM > To: Malik,Imrana [[email protected]] > CC: [email protected] [[email protected]] > Subject: Re: [Sepsis Groups] SIRS/Sepsis Criteria and Coding > > There is no literature that I am aware of that parses the sirs criteria > however what you say does make sense and is what I actually do in defining > sepsis > > William E. Haik, M.D., F.C.C.P., C.D.I.P. > AHIMA Approved ICD-10-CM/PCS Trainer > Office: (850) 863-2110<tel:(850)%20863-2110> > Cell: (850) 803-5854<tel:(850)%20803-5854> > Fax: (850) 864-4438<tel:(850)%20864-4438> > > > On Jan 17, 2015, at 12:50 PM, Malik,Imrana > <[email protected]<mailto:[email protected]>> wrote: > > > SIRS criteria is only met if 2 out of the 4 are positive, of which one MUST > be a derangement in Temp or WBC. So tachycardia with tachypnea alone should > not be considered positive. Hope that helps. > > > > ________________________________ > From: Sepsisgroups > [[email protected]<mailto:[email protected]>] > on behalf of Orth, Claudia [[email protected]<mailto:[email protected]>] > Sent: Tuesday, January 13, 2015 2:00 PM > To: > [email protected]<mailto:[email protected]> > Subject: [Sepsis Groups] SIRS/Sepsis Criteria and Coding > > I am writing to inquire how other institutions are handling or if you are > even encountering concerns, that we are “over-calling” early sepsis, > especially when the only SIRS criteria are tachycardia and tachypnea > (sometimes only a single set of VS). We are reviewing all short stay > (Observation, 1-2 day stays) and see “septic” patients who are “in no acute > distress”, are only here in Observation status and never Inpatient, or stay > as IP only 1-2 days, are not sent home on any antibiotics or only a short > course of oral antibiotics. > > Often their only SIRS criteria are tachycardia and tachypnea—which are quite > non-specific markers that can be seen with anxiety, pain, etc. but when > paired with a suspected or documented infection role up to Sepsis?! > > Since Sepsis is a high-paying condition it’s also a high audit DRG (mainly > because, in the past, many patients were in ICU, very ill, and expending lots > of resources). Now that “early sepsis” is being diagnosed quite frequently, > external auditors are reviewing sepsis DRG charts, and disagree that sepsis > was present at all, recode the chart, reassign the DRG and reduce payment to > UTI, pneumonia, etc. This is so frustrating as we are trying to educated our > providers and nurses on the importance of having a high suspicion for sepsis > and early recognition and now are turning around and saying don’t say > ‘Sepsis’ unless they are “sick” because we need to be able to defend it!? ☹ > > Any feedback, thoughts, or tools on how other institutions are handling this, > would be greatly appreciated especially when it comes to the SIRS criteria > which most of our clinicians call “soft criteria”? > > Thank you in advance for your time and expertise! > Claudia > Claudia Orth BSN, RN, CCRN-K > Regional Sepsis Coordinator > Munson Medical Center > (231) 935-5692 (Voice) > [email protected]<mailto:[email protected]> > > _______________________________________________ > Sepsisgroups mailing list > [email protected]<mailto:[email protected]> > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
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