: 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.
Would this case qualify as a PTOS patient….I’m not sure because of the location of the fall? This patient came to the ED with GI issues. The patient had been triaged and was waiting in the ED waiting room to be seen when she had a trip and fall in the ED waiting room while walking to the restroom. The fall resulted in a femur fracture and a scalp laceration. I know that if the patient was an Inpatient in our hospital resulting in a fall and a fracture that it would be excluded, but I’m not sure since at the time of the fall, she had not yet been admitted?
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.
If you have a patient that is a transfer and has an admission order but is discharged from the ER because of bed availability, would you have to see if the patient met the other criteria to be a PTOS or just because they were a tx in w/ an admit order makes them a PTOS regardless? I know LOS does not pertain if they do go to the floor and/or ICU but not sure about those that hold in the ER.
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 …
Can you please help me understand if a person who is Osteoporotic with a traumatic mechanism and a fractured bone would be considered PTOS if they meet the other inclusion criteria? I have a trip and fall from standing landing on her knees resulting in a “supracondylar periprosthetic femur fx in an osteoporotic female”. Would this case be a PTOS?
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.
I have a patient that has an “Osteoporotic L4 burst fx” after opening a window and twisting something in her back. I just want to make sure I am thinking correctly that this would be included as a PTOS?
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 …
We had a patient that came in as a possible suicide attempt via hanging but he really didn’t go through with it. He said he chickened out with the hanging but took pills instead. Anyway while in the ER, it was noticed that he had an old wrist lac from a previous suicide attempt via slicing his wrist but he says that he could not find anything sharp enough. We did admit him under medical services for psych eval. We do not know if the attempt with the wrist cutting was within the last 14 days or not. What are your thoughts on this being a PTOS inclusion?
There is currently no flag for the NTDB/TQIP or a check in PTOS that generates if the injury date/time is unknown regarding the 14-day requirement. Therefore, it is the default that patients with unknown injury dates and times are to be considered for inclusion. If the patient has a documented injury that falls within the …
Just to clarify – any patient that gets an injury at ANY acute care hospital and then is transferred into us, we do NOT include. The injury did not need to occur here during their admission…is that correct?
Yes, that is correct based on the current guideline. A fall sustained while a patient at any acute care hospital is considered a complication of medical care and is not picked up.
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 …
A man that was brought in as a pre hospital cardiac arrest. He was evaluated in ED 2 days prior for falls and weakness, was recommended to stay, but signed out AMA. EMS was called to his home for a fall. EMS witnessed seizure like activity followed by unresponsiveness and asystole. He was pronounced in the ED prior to any work up. Would this be a PTOS patient?
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.
If I have a patient that falls from standing getting out of shower with a solitary hip fx, are we to include this as a PTOS patient due to the mechanism code (W18.2) and this falls out of the stated codes listed in the guidelines?
Yes, the code W18.2 is not in the exclusion list and so would meet PTOS criteria.