Release Notes:
Data Element
Version 2018A
| Data Element Name: |
ICD-10-PCS Principal Procedure Date |
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| Collected For: |
All Records, Optional for All HBIPS Records |
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| Definition: | The month, day, and year when the principal procedure was performed.
Note: If transmitted for the HBIPS measure set, all applicable edits (e.g., valid value, ICD-10-PCS Principal Procedure Code exists, etc.) will apply.
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| Suggested Data Collection Question: | What was the date the principal procedure was performed? |
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| Format: |
| Length: | 10 – MM-DD-YYYY (includes dashes) or UTD |
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| Type: | Date |
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| Occurs: | 1 |
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| Allowable Values: |
MM = Month (01-12)
DD = Day (01-31)
YYYY = Year (20xx)
UTD = Unable to Determine |
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| Notes for Abstraction: |
- If the principal procedure date is unable to be determined from medical record documentation, select “UTD.”
- The medical record must be abstracted as documented (taken at “face value”). When the date documented is obviously in error (not a valid date/format or is outside of the parameters of care [after Discharge Date]) and no other documentation is found that provides this information, the abstractor should select “UTD.”
Examples:
- Documentation indicates the ICD-10-PCS Principal Procedure Date was 02-42-20xx. No other documentation in the medical record provides a valid date. Since the ICD-10-PCS Principal Procedure Date is outside of the range listed in the Allowable Values for “Day,” it is not a valid date and the abstractor should select “UTD.”
- Patient expires on 02-12-20xx and documentation indicates the ICD-10-PCS Principal Procedure Date was 03-12-20xx. Other documentation in the medical record supports the date of death as being accurate. Since the ICD-10-PCS Principal Procedure Date is after the Discharge Date (death), it is outside of the parameter of care and the abstractor should select “UTD.”
Note: Transmission of a case with an invalid date as described above will be rejected from the QIO Clinical Warehouse and the Joint Commission’s Data Warehouse. Use of “UTD” for ICD-10-PCS Principal Procedure Date allows the case to be accepted into the warehouse.
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| Suggested Data Sources: |
- Consultation notes
- Diagnostic test reports
- Discharge summary
- Face sheet
- Operative notes
- Procedure notes
- Progress notes
- UB-04
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| Additional Notes: |
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| Guidelines for Abstraction: |
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| Inclusion |
Exclusion |
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None
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None |
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ICD-10-PCS Principal Procedure Date
Specifications Manual for Joint Commission National Quality Measures (v2018A)
Discharges 07-01-18 (3Q18) through 12-31-18 (4Q18)
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