Prevention Quality Indicator 16 (PQI 16) Lower-Extremity Amputation ...

AHRQ Quality IndicatorsTM (AHRQ QITM) ICD-10-CM/PCS Specification v2021

Prevention Quality Indicator 16 (PQI 16) Lower-Extremity Amputation Among Patients with Diabetes Rate July 2021 Area-Level Indicator Type of Score: Rate

Prepared by: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services qualityindicators.

DESCRIPTION Admissions for any listed diagnosis of diabetes and any listed procedure of lower-extremity amputation (except toe amputations) per 100,000 population, ages 18 years and older. Excludes any listed diagnosis of traumatic lower-extremity amputation admissions, obstetric admissions, and transfers from other institutions.

[NOTE: The software provides the rate per population. However, common practice reports the measure as per 100,000 population. The user must multiply the rate obtained from the software by 100,000 to report admissions per 100,000 population.]

NUMERATOR Discharges, for patients ages 18 years and older, with any listed ICD-10-PCS procedure codes for lowerextremity amputation (ACSLEAP *) and any listed ICD-10-CM diagnosis codes for diabetes (ACSLEAD *).

July 2021

1 of 18

AHRQ QITM ICD-10-CM/PCS Specification v2021 PQI 16 Lower-Extremity Amputation Among Patients with Diabetes Rate qualityindicators.

NUMERATOR EXCLUSIONS Exclude cases: ? with any listed ICD-10-CM diagnosis codes for traumatic amputation of the lower extremity (ACLEA2D *) ? with admission source for transferred from a different hospital or other health care facility (Appendix A ) (UB04 Admission source - 2, 3) ? with a point of origin code for transfer from a hospital, skilled nursing facility (SNF) or intermediate care facility (ICF), or other healthcare facility (Appendix A ) (UB04 Point of Origin - 4, 5, 6) ? MDC 14 (pregnancy, childbirth, and puerperium) ? with an ungroupable DRG (DRG=999) ? with missing gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing), principal diagnosis (DX1=missing), or county (PSTCO=missing)

Appendix A ? Admission Codes for Transfers

DENOMINATOR Population ages 18 years and older in metropolitan area1 or county. Discharges in the numerator are assigned to the denominator based on the metropolitan area or county of the patient residence, not the metropolitan area or county of the hospital where the discharge occurred.2

1 The term "metropolitan area" (MA) was adopted by the U.S. Census in 1990 and referred collectively to metropolitan statistical areas (MSAs), consolidated metropolitan statistical areas (CMSAs), and primary metropolitan statistical areas (PMSAs). In addition, "area" could refer to either 1) FIPS county, 2) modified FIPS county, 3) 1999 OMB Metropolitan Statistical Area, or 4) 2003 OMB Metropolitan Statistical Area. Micropolitan Statistical Areas are not used in the QI software. 2 The previous version of this indicator allowed the denominator to be specified with the diabetic population only and calculated with the SAS QI software through the condition-specific denominator at the state-level feature. However, the disease-specific denominator file has been temporarily removed from the software for further review and refinement.

* See below for code list

July 2021

2 of 18

AHRQ QITM ICD-10-CM/PCS Specification v2021 PQI 16 Lower-Extremity Amputation Among Patients with Diabetes Rate qualityindicators.

Lower extremity amputation procedure codes: (ACSLEAP)

0Y620ZZ 0Y630ZZ 0Y640ZZ 0Y670ZZ 0Y680ZZ 0Y6C0Z1 0Y6C0Z2 0Y6C0Z3 0Y6D0Z1 0Y6D0Z2 0Y6D0Z3 0Y6F0ZZ 0Y6G0ZZ 0Y6H0Z1 0Y6H0Z2 0Y6H0Z3 0Y6J0Z1 0Y6J0Z2 0Y6J0Z3 0Y6M0Z0 0Y6M0Z4

Detachment at right hindquarter, open approach Detachment at left hindquarter, open approach Detachment at bilateral hindquarter, open approach Detachment at right femoral region, open approach Detachment at left femoral region, open approach Detachment at right upper leg, high, open approach Detachment at right upper leg, mid, open approach Detachment at right upper leg, low, open approach Detachment at left upper leg, high, open approach Detachment at left upper leg, mid, open approach Detachment at left upper leg, low, open approach Detachment at right knee region, open approach Detachment at left knee region, open approach Detachment at right lower leg, high, open approach Detachment at right lower leg, mid, open approach Detachment at right lower leg, low, open approach Detachment at left lower leg, high, open approach Detachment at left lower leg, mid, open approach Detachment at left lower leg, low, open approach Detachment at right foot, complete, open approach Detachment at right foot, complete 1st ray, open approach

0Y6M0Z5 0Y6M0Z6 0Y6M0Z7 0Y6M0Z8 0Y6M0Z9 0Y6M0ZB 0Y6M0ZC 0Y6M0ZD 0Y6M0ZF 0Y6N0Z0 0Y6N0Z4 0Y6N0Z5 0Y6N0Z6 0Y6N0Z7 0Y6N0Z8 0Y6N0Z9 0Y6N0ZB 0Y6N0ZC 0Y6N0ZD 0Y6N0ZF

Detachment at right foot, complete 2nd ray, open approach Detachment at right foot, complete 3rd ray, open approach Detachment at right foot, complete 4th ray, open approach Detachment at right foot, complete 5th ray, open approach Detachment at right foot, partial 1st ray, open approach Detachment at right foot, partial 2nd ray, open approach Detachment at right foot, partial 3rd ray, open approach Detachment at right foot, partial 4th ray, open approach Detachment at right foot, partial 5th ray, open approach Detachment at left foot, complete, open approach Detachment at left foot, complete 1st ray, open approach Detachment at left foot, complete 2nd ray, open approach Detachment at left foot, complete 3rd ray, open approach Detachment at left foot, complete 4th ray, open approach Detachment at left foot, complete 5th ray, open approach Detachment at left foot, partial 1st ray, open approach Detachment at left foot, partial 2nd ray, open approach Detachment at left foot, partial 3rd ray, open approach Detachment at left foot, partial 4th ray, open approach Detachment at left foot, partial 5th ray, open approach

July 2021

3 of 18

AHRQ QITM ICD-10-CM/PCS Specification v2021 PQI 16 Lower-Extremity Amputation Among Patients with Diabetes Rate qualityindicators.

Diabetes diagnosis codes: (ACSLEAD)

E1010 E1011 E1021 E1022 E1029 E10311 E10319 E10321 E103211 E103212

Type 1 diabetes mellitus with ketoacidosis without coma

Type 1 diabetes mellitus with ketoacidosis with coma

Type 1 diabetes mellitus with diabetic nephropathy

Type 1 diabetes mellitus with diabetic chronic kidney disease

Type 1 diabetes mellitus with other diabetic kidney complication

Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema

Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema

Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema

Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye

E113531 E113532 E113533 E113539 E113541 E113542 E113543 E113549 E113551 E113552

Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye

Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye

Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral

Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye

Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye

Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye

Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral

Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye

Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right eye Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eye

July 2021

4 of 18

AHRQ QITM ICD-10-CM/PCS Specification v2021 PQI 16 Lower-Extremity Amputation Among Patients with Diabetes Rate qualityindicators.

E103213 E103219 E10329 E103291 E103292 E103293 E103299

Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye

E113553 E113559 E11359 E113591 E113592 E113593 E113599

Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye

E10331 E103311

Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema

Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye

E1136

Type 2 diabetes mellitus with diabetic cataract

E1137X1

Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye

E103312

Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye

E1137X2

Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, left eye

E103313

Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral

E1137X3

Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral

E103319

Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye

E1137X9

Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye

E10339

Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema

E1139

Type 2 diabetes mellitus with other diabetic ophthalmic complication

July 2021

5 of 18

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download