Patient Safety Initiative - Case Review System

Specifications (Diagnoses and Procedure Codes) Used to Identify Adverse Events Flagged by the PSI - CRS

 

The following are the specific ICD-9-CM diagnosis and procedure codes which, when present and recorded as acquired (PoA = N) on the hospital bill, will flag the case for review.

 

Adverse Event

ICD-9-CM Diagnosis and Procedure Codes

  • Object left in during surgery

9984 Foreign body accidentally left during a procedure

9987 Acute reaction to foreign substance accidentally left during a procedure.

  • Air embolism

9991 Complications of medical care, not elsewhere classified, air embolism

  • Blood incompatibility

9996 Complications of medical care, not elsewhere classified, ABO incompatibility reaction

  • Pressure ulcer (stage III or IV)

70723 Pressure ulcer, Stage III

70724 Pressure ulcer, Stage IV

  • Falls and trauma (fracture, joint dislocation, head injury, crushing injury, burn, electric shock)

80000 - 82999 Fracture

83000 - 83999 Dislocation

85000 - 85499 Intracranial injury

92500 - 92999 Crushing injury

94000 - 94999 Burn

99100 - 99499 Other and unspecified effects of external causes

  • Catheter-associated urinary tract infection

99664 Infection and inflammatory reaction due to indwelling urinary catheter

1122 Candidiasis of other urogenital sites

59010 Acute pyelonephritis, without lesion of renal medullary necrosis

59011 Acute pyelonephritis, with lesion of renal medullary necrosis

5902 Renal and perinephric abscess

5903 Pyeloureteritis cystica

59080 Pyelonephritis, unspecified

59081 Pyelitis or pyelonephritis in diseases classified elsewhere

5950 Acute cystitis

5970 Urethral abscess

5990 Urinary tract infection, site not specified

  • Vascular catheter-associated bloodstream infection

99931 Infection due to central venous catheter (catheter related blood stream infection (CRBSI))

  • Manifestations of poor glycemic control (diabetic ketoacidosis / hyperosmolarity)

25010 Diabetes with ketoacidosis, Type II or unspecified type, not stated as uncontrolled

25011 Diabetes with ketoacidosis, Type I (juvenile type), not stated as uncontrolled

25012 Diabetes with ketoacidosis, Type II or unspecfied type, uncontrolled

25013 Diabetes with ketoacidosis, Type I (juvenile type), uncontrolled

25020 Diabetes with hyperosmolarity, Type II or unspecified type, not stated as uncontrolled

25021 Diabetes with hyperosmolarity, Type I (juvenile type), not stated as uncontrolled

25022 Diabetes with hyperosmolarity, Type II or unspecified type, uncontrolled

25023 Diabetes with hyperosmolarity, Type I (juvenile type), uncontrolled

24910 Secondary diabetes mellitus with ketoacidosis, not stated as uncontrolled, or unspecified

24911 Secondary diabetes mellitus with ketoacidosis, uncontrolled

24920 Secondary diabetes mellitus with hyperosmolarity, not stated as uncontrolled, or unspecified

24921 Secondary diabetes mellitus with hyperosmolarity, uncontrolled

  • Manifestations of poor glycemic control (hypoglycemic coma in non-diabetics)

2510 Hypoglycemic coma

  • Mediastinitis after coronary artery bypass graft (CABG)

5192 Mediastinitis

plus one of the following procedures:

3610 Aortocoronary bypass for heart revascularization, not otherwise specified

3611 Aortocoronary bypass of one coronary artery

3612 Aortocoronary bypass of two coronary arteries

3613 Aortocoronary bypass of three coronary arteries

3614 Aortocoronary bypass of four or more coronary arteries

3615 Single internal mammary-coronary artery bypass

3616 Double internal mammary-coronary artery bypass

3617 Abdominal-coronary artery bypass

3619 Other bypass anastomosis for heart revascularization

  • Surgical site infection following certain orthopaedic procedures

99667 Infection and inflammatory reaction due to other internal orthopedic device, implant and graft

99859 Other postoperative infection

plus one of the following procedures:

8101 Atlas-axis fusion

8102 Other cervical fusion anterior

8103 Other cervical fusion posterior

8104 Dorsal/dorsolum fusion anterior

8105 Dorsal/dorsolum fusion posterior

8106 Lumbar/lumbosac fusion anterior

8107 Lumbar/lumbosac fusion lateral

8108 Lumbar/lumbosac fusion posterior

8123 Arthrodesis of shoulder

8124 Arthrodesis of elbow

8131 Refusion of atlas-axis

8132 Refusion of other cervical spine anterior

8133 Refusion of other cervical spine posterior

8134 Refusion of dorsal spine anterior

8135 Refusion of dorsal spine posterior

8136 Refusion of lumbar spine anterior

8137 Refusion of lumbar spine lateral

8138 Refusion of lumbar spine posterior

8183 Shoulder arthroplasty NEC

8185 Elbow arthroplasty NEC

  • Surgical site infection following bariatric surgery

27801 Morbid obesity

99859 Other postoperative infection

plus one of the following procedures:

4438 Laparoscopic gastroenterostomy

4439 Other gastroenterostomy

4495 Laparoscopic gastric restrictive procedure

  • Postoperative pulmonary embolism or deep vein thrombosis

Surgical or interventional procedure plus one of the following secondary diagnoses:

4151 Pulmonary embolism and infarction

41511 Iatrogenic pulmonary embolism and infarction

41519 Pulmonary embolism and infarction, other

45340 DVT-embolism lower ext NOS (Oct 04)

45341 DVT-embolism prox lower ext (Oct 04)

45342 DVT-embolism distal lower ext (Oct 04)

 

  • Pulmonary embolism or deep vein thrombosis (for non-surgical patients)

4151 Pulmonary embolism and infarction

41511 Iatrogenic pulmonary embolism and infarction

41519 Pulmonary embolism and infarction, other

45340 DVT-embolism lower ext NOS (Oct 04)

45341 DVT-embolism prox lower ext (Oct 04)

45342 DVT-embolism distal lower ext (Oct 04)

 

  • Postoperative hemorrhage / hematoma*

99811 Hemorrhage complicating a procedure

99812 Hematoma complicating a procedure

plus one of the following procedures:

287

Control of hemorrhage after T&A

3880

Other surgical occlusion of unspecified site

3881

Other surgical occlusion of intracranial vessels

3882

Other surgical occlusion of other vessels of head and neck

3883

Other surgical occlusion of upper limb vessels

3884

Other surgical occlusion of aorta, abdominal

3885

Other surgical occlusion of thoracic vessel

3886

Other surgical occlusion of abdominal arteries

3887

Other surgical occlusion of abdominal veins

3888

Other surgical occlusion of lower limb arteries

3889

Other surgical occlusion of lower limb veins

3941

Control of hemorrhage following vacular surgery

3998

Control of hemorrhage NOS

4995

Control of (postoperative) hemorrhage of anus

5793

Control of (postoperative) hemorrhage of bladder

6094

Control of (postoperative) hemorrhage of prostate

1809

Other incision of external ear

540

Incision of abdominal wall

5412

Reopening of recent laparotomy site

5919

Other incision of perivesicle tissue

610

Incision and drainage of scrotum and tunica and vaginalis

6998

Other operations on supporting structures of uterus

7014

Other vaginotomy

7109

Other incision of vulva and perineum

7591

Evacuation of obstetrical incisional hematoma of perineum

7592

Evacuation of other hematoma of vulva or vagina

8604

Other incision w/ drainage of skin and subcutaneous tissue

  • Postoperative wound dehiscence

5461 Reclosure of postop disruption of abdominal wall

  • Iatrogenic pneumothorax

5121 Iatrogenic pneumothorax

  • Accidental puncture / laceration

9982 Accidental puncture or laceration during a procedure