Typically from a coding perspective, I would clarify with the attending physician, if AFTER STUDY, at the time of discharge if the source of the infection could be identified ( or probably) identified. 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
In a message dated 6/22/2016 9:25:30 A.M. Central Daylight Time, [email protected] writes: I would like to understand how my peers are abstracting a particular issue. I have a question for the group… If you have a patient in the EC and the physician lists as part of the differential diagnoses a UTI or PNA. Then the physician documents as his final EC diagnosis respiratory failure, COPD with exacerbation. Then let’s say the patient does have the clinical signs to support severe sepsis. (temp 102, Pulse 124, Respiratory failure documented and placed on vent). Do you count the differential diagnoses of UTI and PNA as a source of infection in this scenario? Thanks, Debra Debra M. Cox, BSN, RN STTI Member Corporate Quality Specialist | Quality Services 101 East Wood Street | Spartanburg, SC 29303 O: 864-560-2694 | c: 864-327-5731 | f: 864-560-7365 e: _ (tel:(850)%20864-4438) [email protected]_ (mailto:[email protected]) (tel:(850)%20864-4438) | w:_ SpartanburgRegional.com_ (http://www.spartanburgregional.com/) (tel:(850)%20864-4438) "You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete." ~R. Buckminster Fuller From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Tuesday, June 14, 2016 1:07 PM To: [email protected] Cc: [email protected] Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 209, Issue 1 Excellent question. First: The SEP -1 bundle requires that to enter it you must have " 2 + 1" due to infection with the word sepsis in the documentation being enough to satisfy the "infection" part of the bundle. Second: Although Lactate levels > 2 mmol/L are not part of the SOFA score ( Sepsis 3), it is evidence of organ dysfunction in SEP-1 bundle Third: P/F ratios were left out of SEP -1 bundle defining organ dysfunction, (but will be added with the next update), they are part of Sepsis 3 definition SOFA score. Finally: In regards to septic shock, with SEP 1 bundle has evidence of hypoperfusion that persist despite fluid administration as evidenced by blood pressure parameters OR lactate level > 4 mmol/L in a patient with documented severe sepsis, where Sepsis 3 definition requires both with different lactate levels (>2 mmo/L) and requiring vasopressors. To make matters worse as stated earlier, the RACs will apply sepsis 3 definition to non traditional Medicare Get ready to "Rock and Roll" 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: _ (tel:(850)%20864-4438) _(850) 803-5854_ (tel:(850)%20803-5854) _ Fax: _ (tel:(850)%20864-4438) _(850) 864-4438 _ (tel:(850)%20864-4438) (tel:(850)%20864-4438) (tel:(850)%20864-4438) (tel:(850)%20864-4438) _In a message dated 6/14/2016 11:12:03 A.M. Central Daylight Time, [email protected] writes:_ (tel:(850)%20864-4438) (tel:(850)%20864-4438) Send Sepsisgroups mailing list submissions to [email protected] To subscribe or unsubscribe via the World Wide Web, visit http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org or, via email, send a message with subject or body 'help' to [email protected] You can reach the person managing the list at [email protected] When replying, please edit your Subject line so it is more specific than "Re: Contents of Sepsisgroups digest..." Today's Topics: 1. Re: qSOFA (Kramer, George C.) 2. Re: qSOFA (Muhr, Lori) 3. Re: Sepsisgroups Digest, Vol 208, Issue 13 (phoebe atieno) ---------------------------------------------------------------------- Message: 1 Date: Sat, 11 Jun 2016 10:56:16 +0000 From: "Kramer, George C." <[email protected]> To: "Thompson, Tyra" <[email protected]> Cc: "Mileski, William" <[email protected]>, "[email protected]" <[email protected]>, "Enkhbaatar, Perenlei" <[email protected]>, "Fukuda, Satoshi" <[email protected]> Subject: Re: [Sepsis Groups] qSOFA Message-ID: <[email protected]> Content-Type: text/plain; charset="windows-1252" Great question. And do the new SSC guidelines conflict with the CMS SEP-1 bundles in anyway?? My sense is that all of this is getting more complicated with limited added value for the some of the recent changes. Please set me straight. George George Kramer, PhD Professor Director Resuscitation Research Lab Dept. of Anesthesiology UTMB, Galveston 409-939-3040 On Jun 10, 2016, at 12:58 PM, Thompson, Tyra <[email protected]<mailto:[email protected]>> wrote: Greetings, Have any facilities incorporated the new Sepsis definition and guidelines into their practice and would you be willing to share? What were some of your ?first steps? in preparing for your transition? Tyra Thompson, RN Quality Management Specialist Putnam Hospital Center 670 Stoneleigh Avenue l Carmel, NY 10512 l (845)279-5711 Extension 4027 [email protected]<mailto:[email protected]> <image001.png> Health Quest has a secure e-mail policy. To learn more about this policy and how to send and receive confidential and sensitive information, click Here<http://userawareness.zixcorp.com/sites/index.php?b=34097e0b8324f132014f612bd48e2492&type=1&p=0> If you need assistance, please Send a message to the Help Desk<mailto:[email protected]> or call 845-483-6789. The information contained in this e-mail is intended for the use of the named recipient only. It may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient, you are hereby notified that any use, dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify me immediately by using your reply option to advise me of such error. Thank you _______________________________________________ Sepsisgroups mailing list [email protected]<mailto:[email protected] rg> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20160611/106094a0/attachment-0001.htm> ------------------------------ Message: 2 Date: Mon, 13 Jun 2016 14:18:43 +0000 From: "Muhr, Lori" <[email protected]> To: "[email protected]" <[email protected]> Subject: Re: [Sepsis Groups] qSOFA Message-ID: <ac1acc651979404686489f99b6d022004f975...@da1exdb102.jpshealthnetwork.org> Content-Type: text/plain; charset="us-ascii" All The qSOFA is an un-validated screening tool in the hospital environment. It has not been tested in the inpatient environment in a RCT, a quasi-experimental trial, or even a side-by-side trial for screening Sepsis patients. It has been validated in one EMS community in the Seattle area, as an assessment tool for prioritizing patients and run levels. CMS has chosen to stay with methods that have significant research validity to maintain best practice in the care and treatment of the Sepsis patient. Further research needs to be done in both the ED and inpatient areas to validate the use of SIRS, qSOFA, or a combination of these two to develop a strong evidence based tool that can be used by healthcare professionals in multiple environments. Lori J. Muhr DNP, MHSM/MHA, ACNS-BC, APRN-Rx, CCRN, CEN Sepsis Program Manager JPS Health Network Fort Worth, TX -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Friday, June 10, 2016 4:39 PM To: [email protected] Subject: Sepsisgroups Digest, Vol 208, Issue 13 Send Sepsisgroups mailing list submissions to [email protected] To subscribe or unsubscribe via the World Wide Web, visit http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org or, via email, send a message with subject or body 'help' to [email protected] You can reach the person managing the list at [email protected] When replying, please edit your Subject line so it is more specific than "Re: Contents of Sepsisgroups digest..." Today's Topics: 1. qSOFA (Thompson, Tyra) ---------------------------------------------------------------------- Message: 1 Date: Fri, 10 Jun 2016 17:58:20 +0000 From: "Thompson, Tyra" <[email protected]> To: "[email protected]" <[email protected]> Subject: [Sepsis Groups] qSOFA Message-ID: <2B4696B884D50A45852EC0101D3C088BDAAA7D3A@hqex2> Content-Type: text/plain; charset="iso-8859-1" Greetings, Have any facilities incorporated the new Sepsis definition and guidelines into their practice and would you be willing to share? What were some of your "first steps" in preparing for your transition? Tyra Thompson, RN Quality Management Specialist Putnam Hospital Center 670 Stoneleigh Avenue l Carmel, NY 10512 l (845)279-5711 Extension 4027 [email protected] [cid:[email protected]] Health Quest has a secure e-mail policy. To learn more about this policy and how to send and receive confidential and sensitive information, click the link below. http://userawareness.zixcorp.com/sites/index.php?b=34097e0b8324f132014f612bd 48e2492&type=1&p=0 If you need assistance, please contact the Help Desk at hqithelpdesk@he alth-quest.org or call 845-483-6789. The information contained in this e-mail is intended for the use of the named recipient only. It may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient, you are hereby notified that any use, dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify me immediately by using your reply option to advise me of such error. Thank you -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20160610/302b052e/attachment.htm> -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.png Type: image/png Size: 27589 bytes Desc: image001.png URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20160610/302b052e/attachment.png> ------------------------------ Subject: Digest Footer _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org ------------------------------ End of Sepsisgroups Digest, Vol 208, Issue 13 ********************************************* This electronic transmission and any attached files are intended solely for the person or entity to which they are addressed and may contain information that is privileged, confidential or otherwise protected from disclosure under applicable law. Any review, retransmission, dissemination or other use, including taking any action concerning this information by anyone other than the named recipient, is strictly prohibited. If you are not the intended recipient or have received this communication in error, please immediately notify the sender by return email and delete the original message from your system. ------------------------------ Message: 3 Date: Mon, 13 Jun 2016 11:05:31 +0000 (UTC) From: phoebe atieno <[email protected]> To: "[email protected]" <[email protected]> Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 208, Issue 13 Message-ID: <[email protected]> Content-Type: text/plain; charset="utf-8" If CMS only accepts IV antibiotics, why is Augumentin on the list for Monotherapy? Sent from Yahoo Mail on Android On Fri, Jun 10, 2016 at 5:39 PM, [email protected]<[email protected]> wrote: Send Sepsisgroups mailing list submissions to ??? [email protected] To subscribe or unsubscribe via the World Wide Web, visit ??? http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org or, via email, send a message with subject or body 'help' to ??? [email protected] You can reach the person managing the list at ??? [email protected] When replying, please edit your Subject line so it is more specific than "Re: Contents of Sepsisgroups digest..." Today's Topics: ? 1. qSOFA (Thompson, Tyra) ---------------------------------------------------------------------- Message: 1 Date: Fri, 10 Jun 2016 17:58:20 +0000 From: "Thompson, Tyra" <[email protected]> To: "[email protected]" ??? <[email protected]> Subject: [Sepsis Groups] qSOFA Message-ID: <2B4696B884D50A45852EC0101D3C088BDAAA7D3A@hqex2> Content-Type: text/plain; charset="iso-8859-1" Greetings, Have any facilities incorporated the new Sepsis definition and guidelines into their practice and would you be willing to share? What were some of your "first steps" in preparing for your transition? Tyra Thompson, RN Quality Management Specialist Putnam Hospital Center 670 Stoneleigh Avenue l Carmel, NY 10512 l (845)279-5711 Extension 4027 [email protected] [cid:[email protected]] Health Quest has a secure e-mail policy. To learn more about this policy and how to send and receive? confidential and sensitive information, click the link below. http://userawareness.zixcorp.com/sites/index.php?b=34097e0b8324f132014f612bd 48e2492&type=1&p=0 If you need assistance, please contact the Help Desk at [email protected] or call 845-483-6789. The information contained in this e-mail is intended for the use of the named recipient only. It may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient, you are hereby notified that any use, dissemination, distribution or copying of this communication is strictly prohibited. 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