Percentage of Immunocompetent patients with Community-Acquired Pneumonia who receive an initial antibiotic regimen during the first 24 hours that is consistent with current guidelines
Measure Specs
General Information
Numerator
Pneumonia patients who received an initial antibiotic regimen (as specified under the Set Measure Identifier and description in Measure Information Form) consistent with current guidelines during the first 24 hours of their hospitalization.
Denominator
Pneumonia patients 18 years of age or older
Table 3.1 Pneumonia (PN)
ICD-9 Code Shortened Description
481 PNEUMOCOCCAL PNEUMONIA
482.0 K. PNEUMONIAE PNEUMONIA
482.1 PSEUDOMONAL PNEUMONIA
482.2 H.INFLUENZAE PNEUMONIA
482.30 STREPTOCOCCAL PNEUMN NOS
482.31 PNEUMONIA STRPTOCOCCUS A
482.32 PNEUMONIA STRPTOCOCCUS B
482.39 PNEUMONIA OTH STREP
482.40 STAPHYLOCOCCAL PNEU NOS
482.41 METH SUS PNEUM D/T STAPH
482.42 METH RES PNEU D/T STAPH
482.49 STAPH PNEUMONIA NEC
482.82 PNEUMONIA E COLI
482.83 PNEUMO OTH GRM-NEG BACT
482.84 LEGIONNAIRES´ DISEASE
482.89 PNEUMONIA OTH SPCF BACT
482.9 BACTERIAL PNEUMONIA NOS
483.0 PNEU MYCPLSM PNEUMONIAE
483.1 PNEUMONIA D/T CHLAMYDIA
483.8 PNEUMON OTH SPEC ORGNSM
485 BRONCHOPNEUMONIA ORG NOS
486 PNEUMONIA, ORGANISM NOS
Table 3.2 Septicemia
ICD-9 Code Shortened Description
038.0 STREPTOCOCCAL SEPTICEMIA
038.10 STAPHYLCOCC SEPTICEM NOS
038.11 METH SUSC STAPH AUR SEPT
038.12 MRSA SEPTICEMIA
038.19 STAPHYLCOCC SEPTICEM NEC
038.2 PNEUMOCOCCAL SEPTICEMIA
038.3 ANAEROBIC SEPTICEMIA
038.40 GRAM-NEG SEPTICEMIA NOS
038.41 H. INFLUENAE SEPTICEMIA
038.42 E COLI SEPTICEMIA
038.43 PSEUDOMONAS SEPTICEMIA
038.44 SERRATIA SEPTICEMIA
038.49 GRAM-NEG SEPTICEMIA NEC
038.8 SEPTICEMIA NEC
038.9 SEPTICEMIA NOS
995.91 SEPSIS
995.92 SEVERE SEPSIS
Table 3.3 Respiratory Failure
ICD-9 Code Shortened Description
518.81 ACUTE RESPIRATRY FAILURE
518.84 ACUTE & CHRONC RESP FAIL
Table 3.1 Pneumonia (PN)
ICD-10 Code Shortened Description
J 13 Pneumonia due to Streptococcus pneumoniae
J 18.1 Lobar pneumonia, unspecified organism
J 15.0 Pneumonia due to Klebsiella pneumoniae
J 15.1 Pneumonia due to Pseudomonas
J 14 Pneumonia due to Hemophilus influenzae
J 15.4 Pneumonia due to other streptococci
J 15.3 Pneumonia due to streptococcus, group B
J 15.20 Pneumonia due to staphylococcus, unspecified
J 15.21 Pneumonia due to staphylococcus aureus
Z 16 Infection and drug resistant microorganisms
J 15.29 Pneumonia due to other staphylococcus
J 15.5 Pneumonia due to Escherichia coli
J 15.6 Pneumonia due to other aerobic Gram-negative bacteria
A 48.1 Legionnaires’ disease
J 15.8 Pneumonia due to other specified bacteria
J 15.9 Unspecified bacterial pneumonia
J 15.7 Pneumonia due to Mycoplasma pneumoniae
J 16.0 Chlamydial pneumonia
J 16.8 Pneumonia due to other specified infectious organisms
J 18.0 Bronchopneumonia, unspecified organism
J 18.8 Other pneumonia, unspecified organism
J 18.9 Pneumonia, unspecified organism
J 17 Pneumonia in diseases classified elsewhere
J 18.2 Hypostatic pneumonia, unspecified organism
J 85.1 Abscess of lung with pneumonia
Table 3.2 Septicemia
ICD-10 Code Shortened Description
A 40.0 Sepsis due to streptococcus, group A
A 40.1 Sepsis due to streptococcus, group B
A 40.3 Sepsis due to Streptococcus pneumoniae
A 40.8 Other streptococcal sepsis
A 40.9 Streptococcal sepsis, unspecified
A 41.9 Sepsis unspecified
A 41.2 Sepsis due to other unspecified specified staphylococcus
A 41.0 Sepsis due to Staphylococcus aureus
A 41.0 AND U80.1 Sepsis due to Staphylococcus aureus AND Methicillin-resistant staph aureus infection
A 41.1 Sepsis due to other specified staphylococcus
A 41.89 Other specified sepsis
A 41.4 Sepsis due to anaerobes
A 41.50 Gram-negative sepsis, unspecified
A 41.3 Sepsis due to Hemophilus influenzae
A 41.51 Sepsis due to Escherichia coli ( E coli)
A 41.52 Sepsis due to pseudomonas
A 41.53 Sepsis due to Serratia
A 41.59 Other Gram-negative sepsis
A 41.81 Sepsis due to Enterococcus
A 42.7 Actinomycotic sepsis
A 41.9 Sepsis, unspecified
R65.20 Severe sepsis without septic shock
R65.21 Severe sepsis with septic shock
Table 3.3 Respiratory Failure
ICD-10 Code Shortened Description
J 96.0 Acute respiratory failure
J 96.9 Respiratory failure, unspecified
J 96.2 Acute and chronic respiratory failure
J 96.1 Chronic respiratory failure
J 80 Acute respiratory syndrome
J 22 Unspecified acute lower respiratory infection
J 98.8 Other specified respiratory disorders
Exclusions
Patients less than 18 years of age
Patients who have a length of stay greater than 120 days
Patients with Cystic Fibrosis
Patients who had no chest x-ray or CT scan that indicated abnormal findings within 24 hours prior to hospital arrival or anytime during the hospitalization
Receiving comfort measures only documented the day of or the day after arrival
Patients enrolled in a clinical trial
Patients received as a transfer from the emergency/observation department of another hospital
Patients received as a transfer from an ambulatory surgery center
Patients received as a transfer from an inpatient or outpatient department of another hospital
Patients who have no diagnosis of pneumonia either as the ED final diagnosis/impression or direct admission diagnosis/impression
Patients who are Compromised as defined in data dictionary (i.e., documentation that the patient had (1) any of the following compromising conditions: HIV positive, AIDS, cystic fibrosis, systemic chemotherapy within last three months, systemic immunosuppressive therapy within the past three months, leukemia documented in the past three months, lymphoma documented in the past three months, radiation therapy in the past three months; With healthcare associated pneumonia as defined in data dictionary (i.e., presence of at least one of the following: (1) hospitalization within the last 90 calendar days; (2) residence in a nursing home or extended care facility for any amount of time within the last 90 days; (3) chronic dialysis within the last 30 days prior to this hospitalization; (4) wound care, tracheostomy care or ventilator care provided by a health care professional within the last 30 days) and abstraction guidelines
Patients transferred/admitted to the ICU within 24 hours after arrival to this hospital with a beta-lactam allergy
Patients who have a duration of stay less than or equal to one day
Patients with another source of infection who did not receive an antibiotic regimen recommeneded for pneumonia but did receive antibiotics within the first 24 hours of hospitalization
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