Data Quality Task Force

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Data Quality Task Force

• Chart Review
• Diabetic Chart / Workshop November 1, 2004

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• Comorbidities
• Comorbidities are all conditions that coexist at
  the time of admission or
• develop subsequently and demonstrate at least one
  of the following
• significantly affects the treatment received
• requires treatment beyond maintenance of the
  preexisting condition
• increases the length of stay (LOS) by at least 24
  hours.
• Consider the following in determining whether a
  condition qualifies as a comorbidity.
• To support a determination of significance, there
  must be documented evidence in
• the physicians notes or discharge summary that
  the condition required at least one
• of the following
• clinical evaluation/consultation, excluding
  pre-operative anesthetic consults, where a
• new or amended course of treatment is
  recommended and instituted
• therapeutic treatment/intervention with a code
  assignment of 50 or greater
• from Section 1 of CCI
• diagnostic intervention, inspection or biopsy
  with a code assignment from

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Diagnosis Type (2).Post-admit Comorbidity A
Diagnosis Type (2) is a condition that arises
post-admission, has been assigned an ICD-10-CA
code and satisfies the requirements for
determining comorbidity. Reference
Canadian Coding Standards ICD-10-CA and CCI 2004
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ER PORTION
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No General Consensus reached on the ER portion of
the Chart
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• Common Diabetic Coding Errors
• Dagger / Asterisk Standard not being followed.
• Every Diabetic Complication package will have at
  least three codes with
• the exception of foot ulcer.
• example
• E11.224 1 Diabetic Code (dagger)
• N08.3 3 Mandatory Asterisk code must be
  a type 3
• N18.9 3 Complication code must be a
  type 3
• Diabetic Control can not be determined using
  glucometer readings
• Diabetic typing will only be M or 1 when the
  condition is treated,
• never a type 2.
• If a diabetic complication is treated while in
  hospital, it is coded
• separately under that complication as a M or
  type 1.
• Generally if a condition is not treated during
  the admission, it will go
• under the multiple complication code as a type
  3 should the hospital
• choose to code these.
• All diabetic codes on the same chart must have
  the same level of control
• (sixth digit).

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?? Questions ??