Never Events and Preventable
Adverse Events are considered adverse events or errors in medical care that are
clearly identifiable, preventable, and serious in their consequences for
patients. They address injuries caused by errors in medical and surgical
management and errors that occur as a result of a failure to follow standards
of care or hospital policies and procedures.
Based on recent regulations published
by the Centers for Medicare & Medicaid Services (CMS), our Claim Payment
Policy #00.01.44e: Never Events and Preventable Adverse Events will be updated
as outlined below and will be effective February 5, 2013.
The following
Hospital Acquired Conditions and associated diagnosis and procedure codes will
be added to the section of the policy addressing preventable adverse
events:
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Surgical Site Infection (SSI)
Following Cardiac Implantable Electronic Device (CIED) Procedures
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996.61 Infection and inflammatory reaction due to
cardiac device, implant and graft
998.59 Other postoperative infection
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00.50 ? 00.54; 37.74 ? 37.77;
37.79; 37.80 ? 37.83; 37.85 ? 37.87; 37.89; 37.94; 37.96; 37.98
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latrogenic Pneumothorax With Venous
Catheterization
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512.1 Iatrogenic Pneumothorax
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38.93
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The following
two diagnoses codes will be added to Vascular Catheter-Associated
Infection:
999.32
Bloodstream infection due to central venous catheter
999.33
Local infection due to central venous catheter
For questions or additional information
related to Never Events and Preventable Adverse Events, please contact your
Network Coordinator or Hospital/Ancillary Services Coordinator.