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Postoperative Respiratory Failure Rate (PSI 11)

CBE ID
0533
1.4 Project
Surgery
Endorsed
Endorsement Status
Endorsement Removed
1.1 New or Maintenance
Maintenance
E&M Cycle
Fall 2019
Is Under Review
No
1.3 Measure Description

Postoperative respiratory failure (secondary diagnosis), prolonged mechanical ventilation, or reintubation cases per 1,000 elective surgical discharges for patients ages 18 years and older. Excludes cases with principal diagnosis for acute respiratory failure; cases with secondary diagnosis for acute respiratory failure present on admission; cases in which tracheostomy is the only operating room procedure or in which tracheostomy occurs before the first operating room procedure; cases with neuromuscular disorders, laryngeal, pharyngeal or craniofacial surgery, esophageal resection, lung cancer, lung transplant or degenerative neurological disorders; cases with a procedure on the nose, mouth, or pharynx; cases with respiratory or circulatory diseases; and obstetrics charges.

    • 1.5 Measure Type
      Outcome
      1.7 Electronic Clinical Quality Measure (eCQM)
      No
      1.8 Level Of Analysis
      Facility
      1.9 Care Setting
      Hospital
      1.20 Testing Data Sources
      Claims Data
    • 1.14 Numerator

      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 secondary ICD-10-PCS 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 secondary ICD-10-PCS 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 secondary ICD-10-PCS 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)

    • 1.15 Denominator

      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 (SID ATYPE=3).

    • Exclusions

      Exclude cases:
      • with a principal ICD-10-CM diagnosis code (or secondary diagnosis present on admission) for acute respiratory failure (see below)
      • where the only operating room procedure is tracheostomy
      • where a procedure for tracheostomy occurs before the first operating room procedure†
      • with any-listed ICD-10-CM diagnosis codes for neuromuscular disorder
      • with any-listed ICD-10-PCS procedure codes for laryngeal or pharyngeal, nose, mouth, pharynx or facial surgery
      • with any-listed ICD-10-PCS procedure codes for esophageal resection
      • with any-listed ICD-10-PCS procedure codes for lung cancer
      • any-listed ICD-10-CM diagnosis codes for degenerative neurological disorder
      • with any-listed ICD-10-PCS 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)
      • with missing gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing), or principal diagnosis (DX1=missing)

    • Most Recent Endorsement Activity
      Measure Retired and Endorsement Removed Surgery Fall Cycle 2019
      Initial Endorsement
      Last Updated
      Removal Date