The PSI 90 composite measure summarizes patient safety across multiple indicators for the CMS Medicare fee-for-service population.
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1.5 Measure Type1.7 Electronic Clinical Quality Measure (eCQM)1.8 Level Of Analysis1.9 Care Setting1.20 Testing Data Sources
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1.14 Numerator
PSI 03: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any secondary ICD-10-CM diagnosis codes for pressure ulcer stage III or IV (or unstageable).
PSI 06: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any secondary ICD-10-CM diagnosis codes for iatrogenic pneumothorax.
PSI 08: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any secondary ICD-10-CM diagnosis codes for hip fracture.
PSI 09: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with: any secondary ICD-10-CM diagnosis codes for perioperative hemorrhage or hematoma and any-listed ICD-10-CM procedure codes for treatment of hemorrhage or hematoma (Note: The ICD-10-CM specification is limited to postoperative hemorrhage or hematoma).
PSI 10: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any secondary ICD-10-CM diagnosis codes for acute renal failure and any-listed ICD-10-CM procedure codes for dialysis.
PSI 11: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with either: any secondary ICD-10-CM diagnosis code for acute respiratory failure; or any-listed ICD-10-CM procedure codes for a mechanical ventilation for 96 consecutive hours or more that occurs zero or more days after the first major operating room procedure code (based on days from admission to procedure); or any-listed ICD-10-CM procedure codes for a mechanical ventilation for less than 96 consecutive hours (or undetermined) that occurs two or more days after the first major operating room procedure code (based on days from admission to procedure); or any-listed ICD-10-CM procedure codes for a reintubation that occurs one or more days after the first major operating room procedure code (based on days from admission to procedure).
PSI 12: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with a secondary ICD-10-CM diagnosis code for proximal deep vein thrombosis or a secondary ICD-10-CM diagnosis code for pulmonary embolism.
PSI 13: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any secondary ICD-10-CM diagnosis codes for sepsis.
PSI 14: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any-listed ICD-10-PCS procedure codes for repair of the abdominal wall and any-listed ICD-10-CM diagnosis code for disruption of internal surgical wound
PSI 15: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any secondary ICD-10-CM diagnosis codes for accidental puncture or laceration during a procedure and second abdominopelvic operation >=1 day after an index abdominopelvic operation.
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1.15 Denominator
PSI 03: Surgical or medical discharges, for patients ages 18 years and older. Surgical and medical discharges are defined by specific MS-DRG codes.
PSI 06: Surgical and medical discharges, for patients ages 18 years and older. Surgical and medical discharges are defined by specific MS-DRG codes.
PSI 08: Discharges, for patients ages 18 years and older, in a medical DRG or in a surgical DRG, with any listed ICD-10-PCS procedure codes for an operating room procedure.
PSI 09: Surgical discharges, for patients ages 18 years and older, with any-listed ICD-10-PCS procedure codes for an operating room procedure. Surgical discharges are defined by specific MS-DRG codes.
PSI 10: Elective surgical discharges, for patients ages 18 years and older, with any-listed ICD-10-PCS procedure codes for an operating room procedure. Elective surgical discharges are defined by specific MS-DRG codes with admission type recorded as elective.
PSI 11: Elective surgical discharges, for patients ages 18 years and older, with any-listed ICD-10-PCS procedure codes for an operating room procedure. Elective surgical discharges are defined by specific MS-DRG codes with admission type recorded as elective.
PSI 12: Surgical discharges, for patients ages 18 years and older, with any-listed ICD-10-PCS procedure codes for an operating room procedure. Surgical discharges are defined by specific MS-DRG codes.
PSI 13: Elective surgical discharges, for patients ages 18 years and older, with any-listed ICD-10-PCS procedure codes for an operating room procedure. Elective surgical discharges are defined by specific MS-DRG codes with admission type recorded as elective.
PSI 14: Discharges, for patients ages 18 years and older, with any-listed ICD-10-CM procedure codes for abdominopelvic surgery, open approach, or with any-listed ICD-10-PCS procedure codes for abdominopelvic surgery, other than open approach.
PSI 15: Surgical and medical discharges, for patients ages 18 years and older, with any ICD-10-PCS procedure code for an abdominopelvic procedure
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Exclusions
PSI 03:
-Length of stay of less than 3 days
-Principal ICD-10-CM diagnosis code for pressure ulcer stage III or IV (or unstageable)
- All secondary ICD-10-CM diagnosis codes for pressure ulcer III or IV (or unstageable) present on admission. If more than one diagnosis of pressure ulcer is present, all diagnoses must be present on admission for the discharge to be excluded
-Any listed ICD-10-CM diagnosis code for severe burns (>20% body surface area)
-Any listed ICD-10-CM diagnosis code for exfoliative disorders of the skin (>20% body surface area)
-MDC 14 (pregnancy, childbirth, and puerperium)
-Missing gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing), or principal diagnosis (DX1=missing)
PSI 06:
- Principal ICD-10-CM diagnosis code for iatrogenic pneumothorax
-Any secondary ICD-10-CM diagnosis code for iatrogenic pneumothorax present on admission, among patients qualifying for the numerator
-Any listed ICD-10-CM diagnosis codes for specified chest trauma (rib fractures, traumatic pneumothorax and related chest wall injuries)
-Any listed ICD-10-CM diagnosis codes for pleural effusion
-Any listed ICD-10-PCS procedure codes for thoracic surgery
-Any listed ICD-10-CM procedure codes for cardiac procedure;
-MDC 14 (pregnancy, childbirth, and puerperium)
-Missing gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing), or principal diagnosis (DX1=missing)
PSI 08:
- Principal ICD-10-CM diagnosis code for hip fracture
-Any secondary ICD-10-CM diagnosis code for hip fracture present on admission, among patients otherwise qualifying for the numerator
- Principal ICD-10-CM diagnosis code for seizure
- Principal ICD-10-CM diagnosis code for syncope
- Principal ICD-10-CM diagnosis code for stroke and occlusion of arteries
- Principal ICD-10-CM diagnosis code for coma
- Principal ICD-10-CM diagnosis code for cardiac arrest
- Principal ICD-10-CM diagnosis code for poisoning
- Principal ICD-10-CM diagnosis code for trauma
- Principal ICD-10-CM diagnosis code for delirium and other psychoses
- Principal ICD-10-CM diagnosis code for anoxic brain injury
-Any listed ICD-10-CM diagnosis codes for metastatic cancer
-Any listed ICD-10-CM diagnosis codes for lymphoid malignancy
-Any listed ICD-10-CM diagnosis codes for bone malignancy
-MDC 14 (pregnancy, childbirth, and puerperium)
-Missing gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing), or principal diagnosis (DX1=missing)
PSI 09:
-Principal ICD-10-CMS diagnosis code for perioperative hemorrhage or postoperative hematoma
-Any secondary ICD-10-CM diagnosis present on admission for perioperative hemorrhage or postoperative hematoma, among discharges that otherwise qualify for the numerator
-The only operating room procedure is for treatment of perioperative hemorrhage, or hematoma and with any secondary ICD-10-CM diagnosis codes for perioperative hemorrhage or hematoma
-Treatment of postoperative hemorrhage or hematoma occurs one day or more before the first operating room procedure, and with any secondary ICD-10-CM diagnosis codes for postoperative hemorrhage or hematoma
-With any listed ICD-10-CM diagnosis codes for coagulation disorders
-MDC 14 (pregnancy, childbirth, and puerperium)
-Missing gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing), or principal diagnosis (DX1=missing)
PSI 10:
-Principal ICD-10-CM diagnosis code for acute renal failure, cardiac arrest, cardiac dysrhythmia, shock or chronic kidney failure
-Any secondary ICD-10-CM diagnosis code for acute kidney failure, cardiac arrest, cardiac dysrhythmia, shock or chronic kidney failure, present on admission, among patients otherwise qualifying for the numerator
-Any dialysis procedure that occurs before or on the same day as the first operating room procedure
-Any dialysis access procedure occurring before or on the same day as the first operating room procedure
-Principal ICD-10-CM (or secondary diagnosis present on admission) for urinary tract obstruction
-Any ICD-10-CM diagnosis code present on admission for solitary kidney disease and any ICD-10-PCS procedure code for partial nephrectomy
-MDC 14 (pregnancy, childbirth, and puerperium)
-Missing gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing), or principal diagnosis (DX1=missing)
PSI 11:
-Principal ICD-10-CM diagnosis code for acute respiratory failure
-Any secondary ICD-10-CM diagnosis code for respiratory failure present on admission, among patients otherwise qualifying for the numerator
-Only operating room procedure is tracheostomy
-Procedure for tracheostomy occurs before the first operating room procedure
-Any listed ICD-10-CM diagnosis codes for neuromuscular disorder
-Any listed ICD-10-PCS procedure codes for laryngeal or pharyngeal, nose, mouth pharynx or facial surgery
- Any listed ICD-10-CM procedure codes for esophageal resection
- Any listed ICD-10-CM procedure codes for lung cancer
- Any listed ICD-10-CM diagnosis codes for degenerative neurological disorder
- Any listed ICD-10-CM procedure codes for lung transplant
-MDC 4 (diseases/disorders of respiratory system);
-MDC 5 (diseases/disorders of circulatory system);
-MDC 14 (pregnancy, childbirth, and puerperium)
-Missing gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing), or principal diagnosis (DX1=missing)
PSI 12:
-Principal ICD-10-CM diagnosis code for proximal deep vein thrombosis (DVT) or pulmonary embolism (PE),
-Any secondary ICD-10-CM diagnosis code for DVT or PE present on admission, among patients otherwise qualifying for the numerator
-Procedure for interruption of vena cava occurs before or on the same day as the first operating room procedure
-Only operating room procedure was interruption of vena cava
-Any listed ICD-10-CM diagnosis code for acute brain or spinal injury present on admission
-Any listed ICD-10-PCS procedure code for extracorporeal membrane oxygenation (ECMO)
-Procedure for pulmonary arterial thrombectomy occurs before or on the same day as the first operating room procedure
-Only operating room procedure was for pulmonary arterial thrombectomy
-MDC 14 (pregnancy, childbirth, and puerperium)
-Missing gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing), or principal diagnosis (DX1=missing)
PSI 13:
-Principal ICD-10-CM diagnosis code for sepsis or infection
-Any secondary ICD-10-CM diagnosis code for sepsis or infection present on admission, among patients otherwise qualifying for the numerator
-MDC 14 (pregnancy, childbirth, and puerperium)
-Missing gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing), or principal diagnosis (DX1=missing)
PSI 14:
-Procedure for abdominal wall reclosure occurs on or before the day of the first open abdominopelvic surgery procedure, if any, and the day of the first laparoscopic abdominopelvic surgery procedure, if any
-Any listed ICD-10-CM diagnosis codes or any-listed ICD-10-PCS procedure codes for immunocompromised state
-Principal ICD-10-CM diagnosis code for disruption of internal operation wound
-Any secondary ICD-10-CM diagnosis code for disruption of internal operation wound present on admission
-Length of stay less than two (2) days-MDC 14 (pregnancy, childbirth, and puerperium)
-Missing gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing), or principal diagnosis (DX1=missing)
PSI 15:
-Principal ICD-10-CM diagnosis code for accidental puncture or lacerations during a procedure
-Any secondary ICD-10-CM diagnosis code for accidental puncture or laceration during a procedure, among patients otherwise qualifying for the numerator
-MDC 14 (pregnancy, childbirth, and puerperium)
-Missing gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing), or principal diagnosis (DX1=missing)
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Most Recent Endorsement ActivityEndorsed Patient Safety Fall Cycle 2020Initial EndorsementLast Updated
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StewardCenters for Medicare & Medicaid ServicesSteward Organization POC Email
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Risk Adjustment
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6.1.2 Current or Planned Use(s)6.1.3 Current Use(s)
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