trauma room

When the patient is made CMO prior to meeting PTOS then they are excluded. So with your patient in the ED, assuming they haven’t met the LOS requirement prior to the determination for comfort measures, then they would be excluded.If your patient was in the ED for extended time and met LOS before they went …

The patient had a new mechanism of injury (fall), and since he expired rapidly and no workup was completed, he can be captured as PTOS.

Yes, the code W18.2 is not in the exclusion list and so would meet PTOS criteria.

If this second encounter is based on the same injury due to the fall as the first encounter, you will not capture as PTOS. If there is documentation that there was a new injury mechanism (i.e. another fall), the patient would be considered for PTOS as long as there was also a diagnosis that falls …

Appendix 15 are examples for our solitary hip fracture exclusion. In order for a patient to meet this exclusion the patient must sustain a solitary hip fracture from a fall on the same level. It does not sound like from the information you provided that the patient fell. Therefore, the patient would not meet the …

It all comes down to the ICD-10-CM diagnosis code. Lacerations do typically fall within our ICD-10-CM inclusion code range. It is the superficial abrasions and contusions that are excluded. If the patient has an ICD-10-CM diagnosis code that falls within the PTOS inclusion code range AND the patient meets another portion of the criteria (i.e. …

No, if the injuries are due to the disease then you won’t pick it up. Another example would be osteophytes on a vertebra. You can pick up a fractured vertebra, but not a fractured osteophyte.

If the patient is in an acute care hospital, and falls, that record won’t meet inclusion criteria. In other locations such as a SNF, residential care, or a psychiatric center that is not an acute care hospital, those do qualify for inclusion.

That’s correct. The patient was discharged home from the ED. She went home and did not meet LOS and so does not qualify as PTOS.In order for Stepdown or ICU to be qualifying criteria, the patient actually has to go to the unit.

Yes, if the injury occurs after the patient is in your hospital being treated, then that is not a qualifying injury. The idea is that those patients are being reviewed through another quality review in your hospital, so are not picked up for PTOS or NTDS.