In addition, the Department of Health and Human . Four (0.03%) women were diagnosed with both postoperative cellulitis and deep or organ-space SSI. For these reasons, the NHSN ategory "OTH" will not be mapped to ID-10-PS and PT codes and the procedures in that group will not be . diagnosis or procedure code indicative of a possible SSI. The updated 2018 NHSN ICD‐10‐PCS and CPT operative procedure codes became available recently. Note: The former NHSN Category "OTH - other" is not mapped to ICD-10-PCS and CPT NHSN operative procedure codes. Chapter 9 Surgical Site Infection (SSI) Event . Results: The strict SSI algorithm was able to classify SSI status for 27.3% of discharges; there was a high number of indeterminate cases. procedures. In several instances, multiple NHSN procedure codes were mapped to a single SCIP procedure (Appendix A). • NHSN data included 16,147 SSIs following 849,659 operative procedures in all groups reported, for an overall SSI rate of 1.9% between 2006-2008. 4. NOTE: As of 2014, incisional closure is NO LONGER a part of the NHSN operative procedure The ICD-10-PCS/CM code mapping guidance is found on the NHSN website in the SSI section under "Supporting Materials." not includes all procedure-related SSIs identified (i.e., superficial, deep and organ space SSIs). Surgical Site Infection (SSI) Event : 34 ; Post-Procedure Pneumonia (PPP) Event : 39 ; . Detailed information regarding the NHSN system and SSI module and reporting requirements, including procedure codes included in the operative . Where can I find information about the ICD-10 codes for the CDC/NHSN surgical site infection (SSI) measures? Hysterectomy procedures / codes that involve an incision into the abdomen, including trocar insertion are categorized as NHSN HYST - abdominal hysterectomy procedures; therefore, a few of the CPT codes that include " laparoscopy, surgical, with vaginal hysterectomy " in the procedure description are included in the HYST procedure category. Although the original ICD-9 codes are outdated, the required NHSN procedure types (PDF) remain the same. denominators, required by the NHSN for SSI reporting, . Mappings to ICD-10-CM Codes and CPT Codes NHSN Patient Safety Manual: Chapter 9. DATES: Written comments must be received on or before May 31, 2019. The 2021 ICD-10 Procedure Coding System (ICD-10-PCS) files below contain information on the ICD-10-PCS updates for FY 2021. •Average cost of a HAI SSI is $28, 2191 1 AHRQ National Scorecard on Hospital‐Acquired Conditions Updated Baseline Rates and Preliminary Results 2014‐2017 Key Concepts Monthly Reporting Plan: HEALTHCARE-ASSOCIATED INFECTIONS PROGRAM Identifying SSI • Engage peri-operative and unit . The cases designated 'prior infection at index joint' = YES should be validated before the procedure is submitted to NHSN. COLO - Colon Surgery. This document includes changes made to the procedure codes listed for 2021 SSI reporting, as well as, new procedure codes added for 2022 SSI reporting. If procedures of different ICD-9-CM codes from the same NHSN Operative Procedure Category are performed through the same incision, record only one . NHSN Procedure-specific SSI Surveillance • Each NHSN operative procedure category consists of a group of ICD-9-CM codes Example: Hip prosthesis (HPRO) include 00.70, 00.71, . 2017 ICD‐10‐PCS and CPT codes lists will remain on the NHSN SSI website until May 15, 2018 under the header "2017 Operative Procedure Code Documents." These lists should only be used for surgical procedures occurring between Jan 1‐Dec 31, 2017. CDC will . Methods. NHSN Patient Safety Manual: Chapter 9. procedures and associated ICD-9 codes 6. DIP - Deep Incisional Primary; GIT - Gastrointestinal tract . Surgical site infection (SSI) Vancomycin-resistant enterococci (VRE) BSI; . While the NHSN currently does not provide a CPT to ICD-9 conversion table, one is expected to be available 2012. NHSN | CDC CDC's National Healthcare Safety Network is the nation's most widely used healthcare-associated infection tracking system. The NHSN surgical site infection (SSI) criteria to be adopted for the Outpatient Procedure Component (OPC) are the same as those currently used for the NHSN, SSI . All Facilities Letter (AFL) Summary. • Surgical procedure category refers to the NHSN procedure code list of International Classification of Diseases, 9th Revision, Clinical Modifications (ICD-9 . On the NHSN Alerts tab labeled Missing Procedures, use the "No Procedures Performed" checkbox for that procedure category for the affected month(s). • For all NHSN procedure categories, superficial SSI are monitored for 30 days only 8. Few studies have validated ICD-9-CM diagnosis codes for SSI after breast procedures, 1 - 3 and to our knowledge, no group has validated coding of noninfectious wound complications (e.g., hematoma, fat necrosis . Q8. Network (NHSN) Manual PATIENT SAFETY COMPONENT PROTOCOL . This document replaces prior documents listing operative procedure codes associated with the NHSN Surgical Site Infection (SSI) Procedure-associated Protocol. Purpose of the Notice: The purpose of the notice is to request input and information from individuals and organizations on a proposed requirement that all procedure and event data submitted as part of the National Healthcare Safety Network's (NHSN) Surgical Site Infection (SSI) Surveillance Module include ICD-10-PCS or CPT codes. The mapping documents include a general definition for each NHSN operative procedure category as well as a description for each individual operative procedure code. HEALTHCARE-ASSOCIATED INFECTIONS PROGRAM . Outpatient . California hospitals have been reporting SSI data NHSN since April 2011,via as specified by two CDPH All Facilities Letters (AFL) [3 and 4]. . We analyzed 3 years (January 1, 2015-December 31, 2017) of laminectomy and rectal surgery SSI data from hospitals in the Duke Infection Control Outreach Network (DICON) that used ICD procedure codes to assign denominators per NHSN definitions. 15. Interpreting SSI Surveillance Requires • Consistent use of standard methods and definitions for Specific Event Code. that is included in the ICD-10-PCS or CPT NHSN operative procedure code mapping and takes place during an operation where at least one incision (including laparoscopic . Surgical Site Infection (SSI) for Outpatient Procedures (SSI-OP): Surveillance for SSI . NHSN Surgical Site Infection Surveillance in 2017 . chapter. Outpatient Procedure. SSI Database Surgical Procedures (January 2013) . Entering the operative procedure code into the NHSN application remains optional. 1. NHSN Operative Procedure Category Mappings to ICD-9-CM Codes and CPT Codes (NHSN will provide updates as needed concerning the transition from ICD-9-CM to ICD-10 procedure coding) When available, ICD-9-CM codes take precedence over CPT codes when determining the appropriate NHSN operative procedure category for inpatient surgery cases. DEFINITIONS •An NHSN operative procedure is a procedure that: • Is included in the ICD‐10‐PCS or CPT NHSN operative procedure code mapping. Additional surgical procedures were identified using CPT-4 and ICD-9-CM procedure codes for an operative procedure on the National Healthcare Safety Network (NHSN) list of procedures for SSI surveillance, including hernia sites not included in this study (epigastric, lumbar, spigelian, and omphalocele). •79,305 SSI for 17 procedures in 20171 •SSI is associated with a mortality rate of 3%, and 75% of SSI‐associated deaths are directly attributable to the SSI. Some surgery systems use current procedural terminology (CPT) codes rather than ICD-9 codes. 16. Long-term Care Facility . ICD-10-CM/PCS Codes for 'prior infection at hip or knee joint' denominator form question - January 2022 [XLSX - 40 KB] An infection associated with a procedure that is not included in one of the NHSN operative procedure categories is not considered an NHSN SSI, Appendix 1: SSI protocol (Link on Page 9-12) SSI? Victoria Russo, MPH, CIC Infection Prevention Consultant . SSI Chapter: Numerator Reporting Instructions Case 9 On 5/15 a 45-year-old female undergoes an abdominal hysterectomy (HYST) and "OTH - Other" is a catch-all category for NHSN operative procedures for which NHSN does not perform any in-plan SSI surveillance nor provide any benchmarking data. (CPT) code mapping for certain NHSN . ICD-9-CM procedure codes, Table 1 provides Current Procedural Terminology (CPT) code mapping for certain NHSN operative procedure categories to assist users in determining the correct . Principle Operative Procedure Selection Lists Mapping of NHSN operative procedures for "ICD-10-PCS and CPT codes" is located in the SSI section under "Supporting Materials" Confirm that the codes that are being used are most Because both outdated (removed) and current procedure codes are included, use caution if this document is used to identify procedures for SSI events for reporting. HEALTHCARE-ASSOCIATED INFECTIONS PROGRAM. 3/1 - Patient admitted to the hospital with colon perforation. Mapping of NHSN operative procedures for "ICD-10-PCS and CPT codes" is located in the SSI section under "Supporting Materials" Confirm that the codes that are being used are most SSI Table 1. The diagnosis code 682.9 was used as an indicator of SSI only if it was on the same claim line as an abdomen-specific CPT-4 code . Surgical Site Infection (SSI) Surveillance Teresa C. Horan, MPH Gloria C. Morrell, RN, MSN, CIC October 3, 2012 . NHSN Operative Procedure Categories ; 62 : Table 13. As in previous years the procedure codes will be versioned, the updates will take effect for Procedure Denominators (and associated SSI events) with a procedure date of 1/1/2019 and going forward 2. What NHSN operative procedure code(s) . procedure. NHSN . *Event Type: SSI *Date of Event: *NHSN Procedure Code: ICD-10-PCS or CPT Procedure Code: *Date of Procedure: *Outpatient Procedure: Yes No *MDRO Infection Surveillance: Yes, this infection's pathogen & location are in-plan for Infection Surveillance in the MDRO/CDI Module No, this infection's pathogen & location are . This validation is necessary to ensure the code is aligned with the index joint revision. . Procedures to Monitor (NHSN Code) Description Includes ICD-9-CM Codes Kidney Transplant (KTP) Transplantation of kidney 55.61, 55.69 Knee Prosthesis (KPRO) Arthroplasty of knee Total, revision 00.80-00.84, 81.54-81.55 HEALTHCARE-ASSOCIATED INFECTIONS PROGRAM. 2 NHSN recommends surveillance for SSIs for 30 days after surgery or 90 days if an . CDC continues to work on updated ICD-10-CM/PCS and CPT mappings to all NHSN operative procedure categories for SSI surveillance. NHSN Operative Procedure • Each NHSN operative procedure category consists of a group of ICD‐9‐CM codes Example: CBGB (CABG with chest and donor site incisions) = ICD‐9 codes 36.10 -36.14, 36.19 • When monitoring a specific NHSN operative procedure category, allthe ICD‐9 codes within that Table 1 provides Current Procedural Terminology (CPT) code mapping for certain NHSN . Eve Giannetta, RN BSN UVAHS Kathy Bailey, RN CIC Centra Health System Janis Ober, RN BSN CIC VCUHS. The update includes a description for each procedure code. The files in the Downloads section below contain information on the ICD-10-PCS COVID-19 updates effective with discharges on and after January 1, 2021. Eligible facilities: For 2014, the facility must be certified as an Ambulatory Surgery Center (ASC) as defined in the Code . Surgical site infection (SSI) is the most common healthcare-associated infection among hospitalized patients in the United States. These 2021 ICD-10-PCS codes are to be used for discharges occurring . Healthcare Personnel Safety . SSI surveillance in the OPC will consist of targeted surveillance of SSI by NHSN operative procedure category. CDC is opening this docket to provide the opportunity to identify challenges for facilities to include ICD-10-PCS or CPT Codes when reporting SSI data to the NHSN, which is proposed to begin in 2021. . SSI specific event types attributed to each NHSN procedure category. NHSN Surgical Site Infection Surveillance in 2017 . 1 SSI incidence reported by the National Healthcare Safety Network (NHSN) after breast operations from 2006-2008 was 2.3% for inpatient and 0.6% for outpatient breast operations. ASCs are required to join Leapfrogs NHSN Group for ASCs if using this option to obtain a security code. . Patient Safety. NHSN Operative Procedure Codes Each NHSN operative procedure category is defined by a group of ICD-9-CM procedure codes CPT codes do not take precedence over ICD-9 And • Takes place during an operation where at least one incision (including laparoscopic approach and cranial Burr hole) is made through the skin or mucous membrane, or reoperation via an incision that was left open during Chapter 9: Surgical Site Infection (SSI) Event Chapter 10: Ventilator-Associated Event (VAE) . or CPT code may be entered here instead of (or in addition to) the NHSN Procedure Code. This validation is necessary to ensure the code is aligned with the index joint revision. 2 operative procedure categories to assist users in determining the correct NHSN code to report for outpatient surgery cases. The second model used discharges that only had NHSN-defined SSI procedures during the same period. The SNFRM was developed using diagnosis codes and procedure codes from ICD-9-CM. NHSN Surgical Site Infection Surveillance in 2017 Victoria Russo, MPH, CIC Infection Prevention Consultant NHSN Training 2017 March 23, 2017. . that procedure record in NHSN. Each NHSN Operative Procedure category consists of a group of ICD-9-CM codes When monitoring a specific NHSN Operative Procedure category, all the ICD-9 codes within that category that are done in your facility must be followed Example: CBGB (CABG with chest and donor site incisions) = ICD-9 codes 36.10 - 36.14, 36.19 The NHSN SSI rate and adjusted SSI rate for rectal surgeries was 0.95 and 2.30, which represents a 58.7% increase. AUTHORITY: Health and Safety Code sections 1288.5 and 1288.8. Surgical Site Infection (SSI) Event Settings: Surveillance of surgical patients will occur in any inpatient and/or outpatient setting . Biovigilance, and Outpatient Procedure (Figure 1). The source of truth for the 2019 procedure codes will be the ICD-10 Procedure Code Mapping to NHSN Operative Procedure Codes and the CPT . These mappings are anticipated to be available by March 2015. The surgical procedure is defined by the National Healthcare Safety Network (NHSN) operative procedure and the ICD-9-CM codes linked to that operative procedure can be found on the NHSN website at Surgical Site Infection (SSI) Event Since 2016, when NHSN combined FUSN and REFUSN into a single procedure . The ICD-10-PCS. SSI Database Surgical Procedures (January 2013) . CDC continues to work on updated ICD-10-CM/PCS and CPT mappings to all NHSN operative procedure categories for SSI surveillance. Statewide Findings Over-Reporting 2,312 SSI procedure cases were reported to NHSN 130 (5.92%) over-reported 92 NHSN Procedure codes not found in HSCRC data 38 HSCRC record not found Inpatient discharge data was not reviewed past Oct. 31, 2015 Outpatient discharge data was not reviewed past Sept. 30, 2015 May not be true over-reports 04/30/2013 5 3. . The cases designated 'prior infection at index joint' = YES should be validated before the procedure is submitted to NHSN. NHSN v8.6 Revisions •Chapter 9 (SSI) Additions "Summary of Operative Procedure Code Changes" which outlines status of each procedure code •Chapter 9 (SSI) Changes Emergency definition for the denominator for procedure was updated so field will match facility documentations ICD-10 and CPT codes reviewed and updated NHSN v8.6 Revisions To be consistent with the NHSN SSI definition, 4 diagnosis of cellulitis of the trunk (682.2) or unspecified site (682.9) on the same claim as a CPT-4 code for incision and drainage was considered evidence of SSI. Background • In 2010, an estimated 16 million operative procedures were performed in acute care hospitals. Picture from NHSN SSI Training, 2016 . Twelve (0.08%) women were diagnosed with both postoperative cellulitis and UTI. IAB - Intraabdominal, not specified elsewhere: For example, the overall SSI incidence after colon surgery was 19.2% but the range was 7.6% (for laparoscopic colectomy . SSI Total = Superficial, Deep, & Organ/Space Superficial Incisional SSI Denominator: All Cases Numerator: Infection occurs within 30 days of the procedure and involves only skin and subcutaneous tissue of the incision and patient has at least 1 of the following: a. purulent drainage from the superficial incision . NHSN Training 2017 March 23, 2017 . Resources for NHSN HAI Reporting Facility staff performing HAI surveillance via NHSN should, at a minimum, complete all relevant self-guided training courses, read all relevant protocols, and become familiar with all relevant forms and Our SSI rates for CBGB, FX, GAST, HYST, 381 317 Statistical analysis LAM, and VSHN were higher than those of the CDC NHSN, but 382 318 similar to those of the INICC. Components. CDPH published the 2015 SSI data for 29 . how to report NHSN operative procedures, see the SSI. However, CPT codes do not take precedence . SSI specific event types attributed to each NHSN procedure category 15 Procedure Code Specific Event Code COLO - Colon Surgery DIP - Deep Incisional Primary GIT - Gastrointestinal tract IAB - Intraabdominal, not specified elsewhere OREP - Other infection of the reproductive tract SIP - Superficial Incisional Primary USI - Urinary System Infection The surgical procedure is defined by the National Healthcare Safety Network (NHSN) operative procedure and the ICD-9-CM codes linked to that operative procedure can be found on the NHSN website at Surgical Site Infection (SSI) Event 1. Procedure codes may be entered in the following manner: • If the ICD-10-PCS procedure code is entered first, the NHSN procedure code name (such as COLO) will be auto-filled by the . This includes all procedure-related SSIs identified (i.e., superficial, deep and organ space SSIs). Dialysis. . January 2017 2 SSI Data Field Instructions for Data Collection . This list of procedures is the same as those procedures specified in the HHS Action Plan as targets of SSI prevention.7 However, there are notable differences between procedure groupings included in SCIP and those in this report. Mappings to ICD-10-CM Codes and CPT Codes . Figure 1: NHSN Components . Since the NHSN procedure code is based on ICD-9-CM code, is the hospital expected to report the denominator procedure data after a patient is discharged (i.e., after the . The overall occurrence of cellulitis (superficial SSI) after hysterectomy was 1.6% (n/N=221/13,822). These mappings are anticipated to be available by March 2015. . If the ICD-10-PCS or CPT code is entered, the NHSN code name will be auto-entered by the computer. Surgical Site Infection Meets criteria for a surgery Meets 30- or 90-day surveillance •All superficial are 30 day Determine depth Look at ICD-10 or CPT code to determine Operative Code . These datasets show surgical site infections (SSIs) reported by California hospitals to the California Department of Public Health (CDPH), Healthcare-Associated Infections (HAI) Program, via the Centers for Disease Control and Prevention National Healthcare Safety Network (NHSN), in accordance with Health and Safety Code (HSC) section 1288.55. The ICD-10-PCS/CM code mapping guidance is found on the NHSN website in the SSI section under " Supporting Materials." Surgical Closure • SSI surveillance required for . Results have been mixed regarding the accuracy of ICD-9-CM diagnosis codes for surgical site infection (SSI) after various procedures. • A post-surgical infection that occurs at the part of the body where an NHSN Operative Procedure took place • NHSN Operative Procedure - Included in NHSN procedure code mapping - At least one incision is made, or reoperation via an incision left open from a prior procedure - Takes place in an operating room Create a report of all procedures performed in a specific time period (1 or 2-week period) 2. If the infection is determined to be a Superficial Incisional SSI, AND the primary CPT code of the patient is listed in Table 1, AND the infection occurred within 30 days of the . The NHSN SSI rate and adjusted SSI rate for laminectomies were 0.50 and 0.72, respec-tively, which represents a 30.6% increase. Procedures to Monitor (NHSN Code) Description Includes ICD-9-CM Codes Kidney Transplant (KTP) Transplantation of kidney 55.61, 55.69 Knee Prosthesis (KPRO) Arthroplasty of knee Total, revision 00.80-00.84, 81.54-81.55 -All ICD-10-PCS codes and all CPT codes were reviewed and updated. based on the same procedure codes used to report in the NHSN. Table 1 provides Current Procedural Terminology (CPT) code mapping for certain NHSN . They also found significant variation within each NHSN surgical category. ICD-10-CM codes included in this spreadsheet are acceptable for use to answer "YES" to "Diabetes Mellitus" for completing the NHSN Operative Procedure Details. . HEALTHCARE-ASSOCIATED INFECTIONS PROGRAM ICD-10 Diagnosis Code SSI Surveillance • Find ICD-10 diagnosis codes in the post-op period to "flag" patients with possible SSI • To apply 1. Same incision, record only one, less strict model, classified 97.2 % of discharges with SSI! 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