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Perioperative Hemorrhage or Hematoma Rate (PSI 09)

CBE ID
2909
Project
Patient Safety
Endorsed
New or Maintenance
Maintenance
Endorsement and Maintenance (E&M) Cycle
Spring 2020
Is Under Review
No
Measure Description

Perioperative hemorrhage or hematoma cases involving a procedure to treat the hemorrhage or hematoma, following surgery per 1,000 surgical discharges for patients ages 18 years and older. Excludes cases with a diagnosis of coagulation disorder; cases with a principal diagnosis of perioperative hemorrhage or hematoma; cases with a secondary diagnosis of perioperative hemorrhage or hematoma present on admission; cases where the only operating room procedure is for treatment of perioperative hemorrhage or hematoma; obstetric cases.

  • Measure Type
    Outcome
    Electronic Clinical Quality Measure (eCQM)
    No
    Level Of Analysis
    Facility
    Care Setting
    Inpatient/Hospital
    Numerator

    Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with:
    • any secondary ICD-9-CM or ICD-10-CM diagnosis codes for perioperative hemorrhage or hematoma and any-listed ICD-9-CM or ICD-10-PCS procedure codes for treatment of hemorrhage or hematoma

    Note that the ICD-10-CM specification is limited to postoperative hemorrhage or hematoma, whereas the ICD-9-CM specification captures both intraoperative and postoperative hemorrhage or hematoma (due to diagnosis codes that are less specific).

    Denominator

    Surgical discharges, for patients ages 18 years and older, with any-listed ICD-9-CM or ICD-10-PCS procedure codes for an operating room procedure. Surgical discharges are defined by specific MS-DRG codes.

    See Appendices: (attached in S.2b)
    • Appendix A – Operating Room Procedure Codes
    • Appendix E – Surgical Discharge MS-DRGs (for discharges on or after October 1, 2007)

    Exclusions

    Exclude cases:
    • with a principal ICD-9-CM or ICD-10-CM diagnosis code (or secondary diagnosis present on admission(1) for perioperative hemorrhage or postoperative hematoma
    • where the only operating room procedure is for treatment of perioperative hemorrhage or hematoma
    • with any secondary ICD-9-CM or ICD-10-CM diagnosis codes for perioperative hemorrhage or hematoma and any-listed ICD-9-CM or ICD-10-PCS procedure codes for treatment of perioperative hemorrhage or hematoma occurring before the first operating room procedure(2)
    • with any-listed ICD-9-CM or ICD-10-CM diagnosis codes for coagulation disorder
    • 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)
    ______________________________
    1. Only for cases that otherwise qualify for the numerator.
    2. If day of procedure is not available in the input data file, the rate may be slightly lower than if the information were available.

    Testing Data Sources
    Claims Data
  • Most Recent Endorsement Activity
    Measure Retired and Endorsement Removed Patient Safety Spring Cycle 2020
    Initial Endorsement
    Endorsement Status
    Endorsement Removed
    Last Updated
    Removal Date