Technical Specifications of Pediatric Ambulatory Care Sensitive Condition Hospitalizations

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1 Technical Specificatins f Pediatric Ambulatry Care Sensitive Cnditin Hspitalizatins Surce: The Canadian Institute fr Health Infrmatin Database(s): Discharge Abstract Database (DAD) Level(s) f Care (facility type): Acute Care (excluding Quebec) Fiscal Year(s): 2014/15 and 2015/16 (cmbined) Scpe: All acute paediatric inpatient recrds, including deaths submitted t the DAD fr fiscal years 2014/15 and 2015/16. Grupings: Neighburhd Incme Quintile f patient pstal cde Cases frm the Yukn, Nrthwest Territries and Nunavut will be gruped, due t the lw number f facilities in these prvinces / territries. 1. ASTHMA Numeratr: Inclusins: Analytical Institutin Type = Acute Inpatient AND Submitting Prvince/Territry = All (excluding Quebec) AND Patients age 2-17 (inclusive, including deaths) years ld nly AND Canadian residents nly (include hmeless and unknwn) AND Mst Respnsible Diagnsis (MRDx) cde f Asthma (J45.-) Exclusins: Newbrns, Stillbirths, and Cadaveric Dnatins AND Obstetrical recrds with the fllwing diagnsis cdes in any psitin: O00 O99 (inclusive) - Pregnancy, Childbirth and the Puerperium Z37.^ - Outcme f Delivery A34 - Obstetrical Tetanus P Terminatin f pregnancy, affecting fetus and newbrn AND Patients with any f the fllwing diagnsis cdes (in any diagnsis cde lcatin) n the abstract: E84.^ - Cystic fibrsis J Other disrders f the lung P27.^ - Chrnic respiratry disease rig. in the perinatal perid P28.^ - Other respiratry disease rig. in the perinatal perid Q30-Q34 - Cngenital malfrmatins f the respiratry system Q Other cngenital malfrmatin f arta Q Cngenital stensis and stricture f esphagus

2 2 Q Oesphageal web Q Situs inversus Denminatr: Inclusins: Analytical Institutin Type = Acute Inpatient AND Submitting Prvince/Territry = All (excluding Quebec) AND Patients age 2-17 (inclusive, including deaths) years ld nly AND Canadian residents nly (include hmeless and unknwn) AND Mst Respnsible Diagnsis (MRDx) cde = any diagnsis cde Exclusins: Newbrns, Stillbirths, and Cadaveric Dnatins AND Obstetrical recrds with the fllwing diagnsis cdes in any psitin: O00 O99 (inclusive) Pregnancy, Childbirth and the Puerperium Z37.^ - Outcme f Delivery A34 - Obstetrical Tetanus P Terminatin f pregnancy, affecting fetus and newbrn Include all acute hspitalizatins where the MRDx is the indicatr f interest, including multiple ccurrences within the tw (2) year study perid. Include all recrds fr the receiving Acute Care facilities where the patient was transferred frm an Emergency Department t the receiving Acute Care facility and the MRDx is the indicatr f interest. Exclude all recrds fr the receiving Acute Care facilities where the patient was transferred frm ne (1) Acute Care facility t the receiving Acute Care facility and the MRDx is the indicatr f interest. 2. DIABETES SHORT TERM COMPLICATIONS Numeratr: Inclusins: Analytical Institutin Type = Acute Inpatient AND Submitting Prvince/Territry = All (excluding Quebec) AND Patients age 6-17 (inclusive, including deaths) years ld nly AND Canadian residents nly (include hmeless and unknwn) AND Mst Respnsible Diagnsis (MRDx) cde f Diabetes: E Type 1 diabetes mellitus with cma E Type 2 diabetes mellitus with cma E Other specified diabetes mellitus with cma E Unspecified diabetes mellitus with cma E Type 1 diabetes mellitus with ketacidsis E Type 2 diabetes mellitus with ketacidsis E Other specified diabetes mellitus with ketacidsis E Unspecified diabetes mellitus with ketacidsis E Type 1 diabetes mellitus with lactic acidsis E Type 2 diabetes mellitus with lactic acidsis

3 3 E Other specified diabetes mellitus with lactic acidsis E Unspecified diabetes mellitus with lactic acidsis E Type 1 diabetes mellitus with ketacidsis with lactic acidsis E Type 2 diabetes mellitus with ketacidsis with lactic acidsis E Other specified diabetes mellitus with ketacidsis with lactic acidsis E Unspecified diabetes mellitus with ketacidsis with lactic acidsis E Type 1 diabetes mellitus with pr cntrl, s described E Type 2 diabetes mellitus with pr cntrl, s described E Other specified diabetes mellitus with pr cntrl, s described E Unspecified diabetes mellitus with pr cntrl, s described Exclusins: Newbrns, Stillbirths, and Cadaveric Dnatins AND Obstetrical recrds with the fllwing diagnsis cdes in any psitin: O00 O99 (inclusive) - Pregnancy, Childbirth and the Puerperium Z37.^ - Outcme f Delivery A34 - Obstetrical Tetanus P Terminatin f pregnancy, affecting fetus and newbrn Denminatr: Inclusins: Analytical Institutin Type = Acute Inpatient AND Submitting Prvince/Territry = All (excluding Quebec) AND Patients age 6-17 (inclusive, including deaths) years ld nly AND Canadian residents nly (include hmeless and unknwn) AND Mst Respnsible Diagnsis (MRDx) cde = any diagnsis cde Exclusins: Newbrns, Stillbirths, and Cadaveric Dnatins AND Obstetrical recrds with the fllwing diagnsis cdes in any psitin: O00 O99 (inclusive) - Pregnancy, Childbirth and the Puerperium Z37.^ - Outcme f Delivery A34 - Obstetrical Tetanus P Terminatin f pregnancy, affecting fetus and newbrn Include all acute hspitalizatins where the MRDx is the indicatr f interest, including multiple ccurrences within the tw (2) year study perid. Include all recrds fr the receiving Acute Care facilities where the patient was transferred frm an Emergency Department t the receiving Acute Care facility and the MRDx is the indicatr f interest. Exclude all recrds fr the receiving Acute Care facilities where the patient was transferred frm ne (1) Acute Care facility t the receiving Acute Care facility and the MRDx is the indicatr f interest.

4 4 3. PERFORATED APPENDIX ADMISSIONS Numeratr: Inclusins: Analytical Institutin Type = Acute Inpatient AND Submitting Prvince/Territry = All (excluding Quebec) AND Patients age 1-17 (inclusive, including deaths) years ld nly AND Canadian residents nly (include hmeless and unknwn) AND Mst Respnsible Diagnsis (MRDx) cde f Acute Appendicitis with Peritnitis: K Acute appendicitis with generalized peritnitis K Acute appendicitis with lcalized peritnitis Exclusins: Newbrns, Stillbirths, and Cadaveric Dnatins AND Obstetrical recrds with the fllwing diagnsis cdes in any psitin: O00 O99 (inclusive) - Pregnancy, Childbirth and the Puerperium Z37.^ - Outcme f Delivery A34 - Obstetrical Tetanus P Terminatin f pregnancy, affecting fetus and newbrn Denminatr: Inclusins: Analytical Institutin Type = Acute Inpatient AND Submitting Prvince/Territry = All (excluding Quebec) AND Patients age 1-17 (inclusive, including deaths) years ld nly AND Canadian residents nly (include hmeless and unknwn) AND Mst Respnsible Diagnsis (MRDx) cde f Appendicitis: K Acute appendicitis with generalized peritnitis K35.3 Acute appendicitis with lcalized peritnitis K35.8 Acute appendicitis, ther and unspecified K36 - Other appendicitis K37 - Unspecified appendicitis Exclusins: Newbrns, Stillbirths, and Cadaveric Dnatins AND Obstetrical recrds with the fllwing diagnsis cdes in any psitin: O00 O99 (inclusive) - Pregnancy, Childbirth and the Puerperium Z37.^ - Outcme f Delivery A34 - Obstetrical Tetanus P Terminatin f pregnancy, affecting fetus and newbrn If a patient has multiple hspital admissins with an MRDx f appendicitis r is transferred t anther acute facility with an MRDx f appendicitis, nly include the first ccurrence, fr that patient, fr that specific indicatr in the numeratr/denminatr. The patient will nly be cunted nce fr this indicatr.

5 5 4. DEHYDRATION AND GASTROENTERITIS (COMBINED) Numeratr: Inclusins: Analytical Institutin Type = Acute Inpatient AND Submitting Prvince/Territry = All (excluding Quebec) AND Patients age 3 mnths -17 (inclusive, including deaths) years ld nly AND Canadian residents nly (include hmeless and unknwn) AND Mst Respnsible Diagnsis (MRDx) cde f Gastrenteritis: A08.^ - Viral and ther specified intestinal infectins A09.^ - Other gastrenteritis and clitis f infectius and unspecified rigin K Nninfective gastrenteritis and clitis, unspecified K Other specified nninfective gastrenteritis and clitis OR Cmbinatin cding f a Mst Respnsible Diagnsis (MRDx) cde f Dehydratin: E86.^ - Vlume depletin P Dehydratin f newbrn AND Gastrenteritis cde with a diagnsis type f 1, 2, W, X, r Y: A08.^ - Viral and ther specified intestinal infectins A09.^ - Other gastrenteritis and clitis f infectius and unspecified rigin K Nninfective gastrenteritis and clitis, unspecified K Other specified nninfective gastrenteritis and clitis Exclusins: Newbrns, Stillbirths, and Cadaveric Dnatins AND Obstetrical recrds with the fllwing diagnsis cdes in any psitin: O00 O99 (inclusive) - Pregnancy, Childbirth and the Puerperium Z37.^ - Outcme f Delivery A34 - Obstetrical Tetanus P Terminatin f pregnancy, affecting fetus and newbrn AND Patients with any f the fllwing diagnsis cdes (in any diagnsis cde lcatin) n the abstract: Bacterial r ther gastrenteritis A02.^ - Other salmnella infectins A03.^ - Shigellsis A04.^ - Other bacterial intestinal infectins A05.^ - Other bacterial fdbrne intxicatins, nt elsewhere classified A06.^ - Amebiasis A07.^ - Other prtzal intestinal diseases B Candidal enteritis Gastrintestinal abnrmalities K50.^ - Crhn's disease [reginal enteritis] K51.^ - Ulcerative clitis K Gastrenteritis and clitis due t radiatin K Txic gastrenteritis and clitis K Allergic and dietetic gastrenteritis and clitis K Indeterminate clitis

6 6 K90.^ - Intestinal malabsrptin K Pstsurgical malabsrptin, nt elsewhere classified K Mucsitis (ulcerative) f the digestive system Denminatr: Inclusins: Analytical Institutin Type = Acute Inpatient AND Submitting Prvince/Territry = All (excluding Quebec) AND Patients age 3 mnths - 17 (inclusive, including deaths) years ld nly AND Canadian residents nly (include hmeless and unknwn) AND Mst Respnsible Diagnsis (MRDx) cde = any diagnsis cde Exclusins: Newbrns, Stillbirths, and Cadaveric Dnatins AND Obstetrical recrds with the fllwing diagnsis cdes in any psitin: O00 O99 (inclusive) - Pregnancy, Childbirth and the Puerperium Z37.^ - Outcme f Delivery A34 - Obstetrical Tetanus P Terminatin f pregnancy, affecting fetus and newbrn Include all acute hspitalizatins where the MRDx is the indicatr f interest, including multiple ccurrences within the tw (2) year study perid. Include all recrds fr the receiving Acute Care facilities where the patient was transferred frm an Emergency Department t the receiving Acute Care facility and the MRDx is the indicatr f interest. Exclude all recrds fr the receiving Acute Care facilities where the patient was transferred frm ne (1) Acute Care facility t the receiving Acute Care facility and the MRDx is the indicatr f interest. 5. URINARY TRACT INFECTION Numeratr: Inclusins: Analytical Institutin Type = Acute Inpatient AND Submitting Prvince/Territry = All (excluding Quebec) AND Patients age 3 mnths -17 (inclusive, including deaths) years ld nly AND Canadian residents nly (include hmeless and unknwn) AND Mst Respnsible Diagnsis (MRDx) cde f Urinary Tract Infectin: N10 - Acute tubule-interstitial nephritis N Renal and perinephric abscess N Acute cystitis N Urinary tract infectin, site nt specified N Renal tubule-interstitial disease, unspecified N12 -Tubul-interstitial nephritis, nt specified as acute r chrnic N Pyelitis cystica N Pyelureteritis cystica

7 7 N Ureteritis cystica Exclusins: Newbrns, Stillbirths, and Cadaveric Dnatins AND Obstetrical recrds with the fllwing diagnsis cdes in any psitin: O00 O99 (inclusive) - Pregnancy, Childbirth and the Puerperium Z37.^ - Outcme f Delivery A34 - Obstetrical Tetanus P Terminatin f pregnancy, affecting fetus and newbrn AND Patients with any f the fllwing diagnsis cdes (in any diagnsis cde lcatin) n the abstract: Immuncmprmised B24 - Human immundeficiency virus [HIV] disease B59 - Pneumcystsis (J17.3*) C81-C96 - Malignant neplasms f lymphid, haematpietic and related tissue D47.^ - Other neplasms f uncertain r unknwn behaviur f lymphid, haematpietic and related tissue D57.^ - Sickle-cell disrders D61.^ - Other aplastic anaemias D80.^ - Immundeficiency with predminantly antibdy defects D81.^ - Cmbined immundeficiencies D82.^ - Immundeficiency assciated with ther majr defects D83.^ - Cmmn variable immundeficiency D84.^ - Other immundeficiencies D89.^ - Other disrders invlving the immune mechanism, nt elsewhere classified T86.^ - Failure and rejectin f transplanted rgans and tissues Z94.^ - Transplanted rgan and tissue status B18.^ - Chrnic viral hepatitis D Hypsplenism D Hypersplenism Q Cngenital malfrmatins f spleen D Chrnic cngestive splenmegaly D Abscess f spleen Kidney/urinary tract abnrmalities N11.^ - Chrnic tubul-interstitial nephritis N13.^ - Obstructive and reflux urpathy N14.^ - Drug- and heavy-metal-induced tubul-interstitial and tubular cnditins N Balkan nephrpathy N Other specified renal tubule-interstitial diseases N16.^ - Renal tubul-interstitial disrders in diseases classified elsewhere N17.^ - Acute renal failure N18.^ - Chrnic kidney disease N19 - Unspecified kidney failure N20-N23 - Urlithiasis N25-N29 - Other disrders f kidney and ureter N Interstitial cystitis (chrnic) N Other chrnic cystitis N Trignitis N Irradiatin cystitis N Other cystitis- includes abscess f bladder/cystitis cystic glandularis

8 8 N Cystitis, unspecified N31.^ - Neurmuscular dysfunctin f bladder, nt elsewhere classified N Bladder-neck bstructin N Tuberculsis cystitis N Bladder disrders in ther diseases classified elsewhere N34.^ - Urethritis and urethral syndrme N35.^ - Urethral stricture N36.^ - Other disrders f urethra N37.^ - Urethral disrders in diseases classified elsewhere N Persistent prteinuria, unspecified N Other specified disrders f urinary system N06.^ - Islated prteinuria with specified mrphlgical lesin Q60-Q64 - Cngenital malfrmatins f the urinary system E1*.23 + N08.3^ - Diabetes Mellitus with ESRD Denminatr: Inclusins: Analytical Institutin Type = Acute Inpatient AND Submitting Prvince/Territry = All (excluding Quebec) AND Patients age 3 mnths - 17 (inclusive, including deaths) years ld nly AND Canadian residents nly (include hmeless and unknwn) AND Mst Respnsible Diagnsis (MRDx) cde = any diagnsis cde Exclusins: Newbrns, Stillbirths, and Cadaveric Dnatins AND Obstetrical recrds with the fllwing diagnsis cdes in any psitin: O00 O99 (inclusive) - Pregnancy, Childbirth and the Puerperium Z37.^ - Outcme f Delivery A34 - Obstetrical Tetanus P Terminatin f pregnancy, affecting fetus and newbrn Include all acute hspitalizatins where the MRDx is the indicatr f interest, including multiple ccurrences within the tw (2) year study perid. Include all recrds fr the receiving Acute Care facilities where the patient was transferred frm an Emergency Department t the receiving Acute Care facility and the MRDx is the indicatr f interest. Exclude all recrds fr the receiving Acute Care facilities where the patient was transferred frm ne (1) Acute Care facility t the receiving Acute Care facility and the MRDx is the indicatr f interest.

ICD-10-CM Coding Basics Chapter Specifics

ICD-10-CM Coding Basics Chapter Specifics ICD-10-CM Cding Basics Chapter Specifics Chapter 15 Pregnancy, Childbirth and the Puerperium Vilma Smith, LVN, CPC, CCS Debra Bales, LVN, CPC Jnay Rischer, CPC 1 Rev. May 2015 ICD-10-CM Cnventins General