Concept

Sepsis identified during a hospital stay, excluding neonatal sepsis.

Notes

This clinical group includes an episode of sepsis that developed in hospital; however, the infection which led to sepsis might have been acquired in the community or hospital.  

Selection Criteria

Codes

Conditions

A40.–

A41.–

B37.7

R57.2

R65.1

Identified as diagnosis type (2)

OR

Identified as diagnosis type (3) AND T80.2, T81.4, T82.6,   T82.7–, T83.5, T83.6, T84.5–, T84.6–, T84.7, T85.7 or T88.0 as diagnosis type (2) AND Y60–Y84 in the same diagnosis cluster

OR

Identified as diagnosis type (3) AND O03.0, O03.5, O04.0, O04.5, O05.0, O05.5, O07.3 or O08.0– as diagnosis type (2) on the same abstract

OR

Identified as diagnosis type (3) AND O98.502 or O98.802 as diagnosis type (M), (1), (2), (W), (X) or (Y) on the same abstract

O85.002

Identified as diagnosis type (M), (1), (2), (W), (X) or (Y)

R57.2

Identified as diagnosis type (3) AND T81.1 as diagnosis type (2) AND Y60–Y84 in the same diagnosis cluster

Exclusions

1. Abstracts with age on admission less than 1 year.
2. Abstracts with a length of stay less than 2 days
3. Abstracts with a most responsible diagnosis of palliative care (ICD-10-CA: Z51:5)
4. Abstracts where sepsis is also identified as a pre-admit condition are excluded from the numerator:

• Abstracts with sepsis codes (ICD-10-CA: A40.–, A41.–, B37.7, R65.1, R57.2) or the associated post-procedural complication codes (ICD-10-CA: T80.2, T81.1, T81.4, T82.6, T82.7–, T83.5, T83.6, T84.5–, T84.6–, T84.7, T85.7, T88.0) identified as pre-admit [type (M), (1), (W), (X) or (Y)]
• Abstract with sepsis in obstetric patients where the puerperal sepsis code or the associated obstetric infection code is identified as pre-admit [ICD-10-CA: O85.004, O85.009, O98.501, O98.503, O98.504, O98.509, O98.801, O98.803, O98.804, O98.809 — any diagnosis type or O03.0, O03.5, O04.0, O04.5, O05.0, O05.5, O07.3, O08.0 as type (M), (1), (W), (X) or (Y)]

As an exception, sepsis is not considered as a pre-admit condition when the above codes identified as type (M), (W), (X) or (Y) also appear as type (2) or within a post-admit sepsis coding scenario (sepsis code as type (2); sepsis code as type (3) or an associated infection code as type (2) in sepsis as post-procedural or obstetric complications

Codes

Code Description

a40

Streptococcal sepsis

A41.–

Other sepsis

b37.7

Candidal sepsis

O03.0

Spontaneous abortion, incomplete, complicated by genital tract and pelvic infection

O03.5

Spontaneous abortion, complete or unspecified, complicated by genital tract and
pelvic infection

O04.0

Medical abortion, incomplete, complicated by genital tract and pelvic infection

O04.5

Medical abortion, complete or unspecified, complicated by genital tract and pelvic infection

O05.0

Other abortion, incomplete, complicated by genital tract and pelvic infection

O05.5

Other abortion, complete or unspecified, complicated by genital tract and pelvic infection

O07.3

Failed attempted abortion, complicated

O08.0–

Complications following abortion and ectopic and molar pregnancy; genital tract and pelvic infection

O85.002

Puerperal sepsis, delivered with mention of postpartum complication

O98.502

Other viral diseases complicating pregnancy, childbirth, and the puerperium; delivered with mention of postpartum complication

O98.802

Other maternal infectious and parasitic diseases complicating pregnancy, childbirth, and the puerperium; delivered with mention of postpartum complication

R57.2

Septic shock

R65.1

Systemic inflammatory response syndrome of infectious origin with acute organ failure

Additional Codes

Inclusions

T80.2

Infections following infusion, transfusion, and therapeutic injection

T81.4

Infection following a procedure, not elsewhere classified

T81.1

Shock during or resulting from a procedure, not elsewhere classified

T82.6

Infection and inflammatory reaction due to cardiac valve prosthesis

T82.7

Infection and inflammatory reaction due to other cardiac and vascular devices, implants, and grafts

T83.5

Infection and inflammatory reaction due to prosthetic device, implant, and graft in urinary system

T83.6

Infection and inflammatory reaction due to prosthetic device, implant, and graft in genital tract

T84.5–

Infection and inflammatory reaction due to internal joint prosthesis

T84.6–

Infection and inflammatory reaction due to internal fixation device (any site)

T84.7

Infection and inflammatory reaction due to other internal orthopedic prosthetic devices, implants, and grafts

T85.7

Infection and inflammatory reaction due to other internal prosthetic devices, implants, and grafts

T88.0

Infection following immunization

Y60–Y84

Complications of medical and surgical care (refer to Appendix A of the Hospital Harm Indicator General Methodology Notes)

Additional Codes

Exclusions

O85.004 

Puerperal sepsis, postpartum condition, or complication

O85.009 

Puerperal sepsis, unspecified as to episode of care, or not applicable

O98.501

Other viral diseases complicating pregnancy, childbirth, and the puerperium; delivered with or without mention of antepartum condition

O98.503

Other viral diseases complicating pregnancy, childbirth, and the puerperium; antepartum condition or complication

O98.504

Other viral diseases complicating pregnancy, childbirth, and the puerperium; postpartum condition or complication

O98.509

Other viral diseases complicating pregnancy, childbirth, and the puerperium; unspecified as to episode of care, or not applicable

O98.801

Other maternal infectious and parasitic diseases complicating pregnancy, childbirth, and the puerperium; delivered with or without mention of antepartum condition

O98.803

Other maternal infectious and parasitic diseases complicating pregnancy, childbirth, and the puerperium; antepartum condition or complication

O98.804

Other maternal infectious and parasitic diseases complicating pregnancy, childbirth, and the puerperium; postpartum condition or complication

O98.809

Other maternal infectious and parasitic diseases complicating pregnancy, childbirth, and the puerperium; unspecified as to episode of care, or not applicable

Z51.5

Palliative care