Quality Transparency Dashboard Sepsis Mortality Calculation (Update Sept 2023)
How does HQI calculate sepsis mortality? (ICD-10-CM)
Description:
In-hospital mortality rate among acute care discharges meeting the modified Dombrovskiy Method proxy case definition for sepsis. While sepsis and septic shock are proxy-diagnosed per the Third International Consensus Definitions for Sepsis and Septic Shock (SEP-3) based on the presence at discharge of a combination of ICD-10-CM codes, it is not strictly the identified cause of death.
Methodology:
The mortality rate calculation via the modified Dombrovskiy Method for sepsis case identification follows this process:
- Identify all inpatient discharges with a diagnosis code (in any position) for septicemia or sepsis
- Identify all inpatient discharges with a diagnosis code (in any position) for organ dysfunction
- Categorize inpatient discharges with a code in both #1 and #2 as sepsis cases
- Determine the percentage of sepsis cases categorized in #3 who received acute care (Type of Care = “1”) and were deceased at discharge (Disposition of Patient = “20”)
Denominator:
Acute-care inpatient discharges meeting the SEP-3 proxy sepsis case definition during the measurement timeframe.
Numerator:
Acute-care inpatient discharges meeting the SEP-3 proxy sepsis case definition during the measurement timeframe with a discharge disposition of “Expired.”
ICD-10-CM CODES TO IDENTIFY SEPTICEMIA OR SEPSIS
| Code | Code Description |
|---|---|
| A02.1 | Salmonella sepsis |
| A20.7 | Septicemic plague |
| A21.7 | Generalized tularemia |
| A22.7 | Anthrax sepsis |
| A26.7 | Erysipelothrix sepsis |
| A32.7 | Listerial sepsis |
| A39.1 | Waterhouse-Friderichsen syndrome |
| A39.2 | Acute meningococcemia |
| A39.3 | Chronic meningococcemia |
| A39.4 | Meningococcemia, unspecified |
| A40.x | Streptococcal sepsis |
| A41.x | Other sepsis |
| A42.7 | Actinomycotic sepsis |
| A54.86 | Gonococcal sepsis |
| B00.7 | Disseminated herpesviral disease |
| B37.7 | Candidal sepsis |
| I26.01 | Septic pulmonary embolism with acute cor pulmonale |
| I26.90 | Septic pulmonary embolism without acute cor pulmonale |
| I76 | Septic arterial embolism |
| O03.37 | Sepsis following incomplete spontaneous abortion |
| O03.87 | Sepsis following complete or unsp spontaneous abortion |
| O04.87 | Sepsis following (induced) termination of pregnancy |
| O07.37 | Sepsis following failed attempted termination of pregnancy |
| O08.82 | Sepsis following ectopic and molar pregnancy |
| O85 | Puerperal sepsis |
| O86.04 | Sepsis following an obstetrical procedure |
| O86.09 | Sepsis following an obstetrical procedure other surgical site |
| O86.81 | Puerperal septic thrombophlebitis |
| O88.3x | Obstetric pyemic and septic embolism |
| P36.x | Bacterial sepsis of newborn |
| R65.2x | Severe Sepsis |
| T81.12xx | Postprocedural septic shock |
| T81.44xx | Sepsis following a procedure |
ICD-10-CM CODES TO IDENTIFY ORGAN DYSFUNCTION
| Code | Code Description |
|---|---|
| A39.1 | Waterhouse-Friderichsen syndrome |
| D65 | Disseminated intravascular coagulation [defibrination syndrome] |
| D69.59 | Other secondary thrombocytopenia |
| D69.6 | Thrombocytopenia, unspecified |
| D69.8 | Other specified hemorrhagic conditions |
| D69.9 | Hemorrhagic condition, unspecified |
| E87.2 | Acidosis |
| E872.0 | Acidosis, unspecified |
| E872.1 | Acute metabolic acidosis |
| E872.2 | Chronic metabolic acidosis |
| E872.9 | Other acidosis |
| E87.4 | Mixed disorder of acid-base balance |
| F05 | Delirium due to known physiological condition |
| F06.0 | Psychotic disorder with hallucinations due to known physiological condition |
| F06.1 | Catatonic disorder due to known physiological condition |
| F06.2 | Psychotic disorder with delusions due to known physiological condition |
| G62.81 | Critical illness polyneuropathy |
| G72.81 | Critical illness myopathy |
| G93.4x | Other and unspecified encephalopathy |
| G93.6 | Cerebral edema |
| G93.82 | Brain death |
| G93.9 | Disorder of brain, unspecified |
| G96.81 | Intracranial hypotension |
| G96.810 | Intracranial hypotension, unspecified |
| G96.811 | Intracranial hypotension, spontaneous |
| G96.819 | Other intracranial hypotension |
| G96.89 | Other specified disorders of central nervous system |
| I46.8 | Cardiac arrest due to other underlying condition |
| I46.9 | Cardiac arrest, cause unspecified |
| I95.1 | Orthostatic hypotension |
| I95.89 | Other hypotension |
| I95.9 | Hypotension, unspecified |
| J80 | Acute respiratory distress syndrome |
| J96.0x | Acute respiratory failure |
| J96.2x | Acute and chronic respiratory failure |
| J96.9x | Respiratory failure, unspecified |
| J98.01 | Acute bronchospasm |
| J98.9 | Respiratory disorder, unspecified |
| J99 | Respiratory disorders in diseases classified elsewhere |
| K59.81 | Ogilvie syndrome |
| K72.0x | Acute and subacute hepatic failure |
| K72.9x | Hepatic failure, unspecified |
| K76.2 | Central hemorrhagic necrosis of liver |
| K76.3 | Infarction of liver |
| K76.7 | Hepatorenal syndrome |
| M35.81 | Multisystem inflammatory syndrome |
| N17.x | Acute kidney failure |
| N19 | Unspecified kidney failure |
| R00.0 | Tachycardia, unspecified |
| R00.1 | Bradycardia, unspecified |
| R03.1 | Nonspecific low blood-pressure reading |
| R06.0 | Dyspnea |
| R06.00 | Dyspnea unspecified |
| R06.03 | Acute respiratory distress |
| R06.09 | Other forms of dyspnea |
| R06.82 | Tachypnea, not elsewhere classified |
| R06.89 | Other abnormalities of breathing |
| R09.02 | Hypoxemia |
| R09.2 | Respiratory arrest |
| R40.0 | Somnolence |
| R40.1 | Stupor |
| R40.20 | Unspecified coma |
| R40.211x | Coma scale, eyes open, never |
| R40.212x | Coma scale, eyes open, to pain |
| R40.213x | Coma scale, eyes open, to sound |
| R40.221x | Coma scale, best verbal response, none |
| R40.222x | Coma scale, best verbal response, incomprehensible words |
| R40.223x | Coma scale, best verbal response, inappropriate words |
| R40.224x | Coma scale, best verbal response, confused conversation |
| R40.231x | Coma scale, best motor response, none |
| R40.232x | Coma scale, best motor response, extension |
| R40.233x | Coma scale, best motor response, abnormal |
| R40.234x | Coma scale, best motor response, flexion withdrawal |
| R40.235x | Coma scale, best motor response, localizes pain |
| R40.242x | Glasgow coma scale score 9-12 |
| R40.243x | Glasgow coma scale score 3-8 |
| R40.244x | Other coma, without documented Glasgow coma scale score, or with partial score reported |
| R40.3 | Persistent vegetative state |
| R57.x | Shock, not elsewhere classified |
| R65.2x | Severe sepsis |
| T81.12xx | Postprocedural septic shock |