trauma room

The patient would be NPTOS for the second encounter. This applies to existing injury and newly identified injury attributed to the same traumatic event.

I agree with you capturing this patient as PTOS and recording them as a transfer out since all of your documentation appears to indicate the patient was to go to the OSF via POV. Starting with 2021 admissions, the requirement for patients to go from one acute care facility to another via EMS or air …

Since this patient is a transfer in, you will include this patient as PTOS. A patient that meets the PTOS inclusion criteria prior to the order for hospice care, or the equivalent, should be captured as PTOS. If the patient would have come directly to your facility, they would have been excluded.

This is a good question. Since the abrasions are not injuries that fall within the accepted PTOS ICD-10-CM code range, this patient should be excluded from PTOS. Note the following isolated injuries are excluded from PTOS:S00, S10, S20, S30, S40, S50, S60, S70, S80, S90, *T68, T71.1 and T75.1 are excluded if no otherinjuries are …

The reason for this inclusion/exclusion guidance is to ensure consistency statewide. It is our hope that this guidance will eliminate hospitals making differing determinations using variables that are not part of the inclusion criteria. You only need to pick them up if they still have a qualifying injury diagnosis. If the patient has a diagnosis …

: Since this patient is a transfer in, you will include this patient as PTOS. A patient that meets the PTOS inclusion criteria prior to the order for hospice care, or the equivalent, should be captured as PTOS. If the patient would have come directly to your facility, they would have been excluded.

No, this patient won’t be PTOS if the injury happened in your hospital while they were a patient. They do not need to be officially admitted, may be in ED or observation.

The current PTOS patient criteria states that patients that are transferred in but discharged home from the ED should be excluded from PTOS. Even if the patient had an admission order, this is based on physical location of the patient. The patient can be captured as PTOS if they meet another portion of the criteria …

These are tricky scenarios, and clarification is typically needed from the provider in order to make a determination. We recommend querying the provider for clarification on whether this is a traumatic or pathological fracture.

No, not necessarily. If they are saying this is osteoporotic, and therefore pathological, then no it wouldn’t be PTOS. That could get coded to M80.08XA, Age-related osteoporosis with current pathological fracture, vertebra OR M80.88XA, Other osteoporosis with current pathological fracture, vertebra. Neither of those two codes are in our inclusion. In order to qualify for …