Tus kws kho mob-Kev tiv thaiv tsis tau - Cov lus txhais​​ 

Title 42 ntawm Txoj Cai ntawm Tsoom Fwv Teb Chaws Txoj Cai, ntu 447, 434 thiab 438 thiab Welfare and Institutions Code (WIC) seem 14131.11 xav kom cov kws kho mob qhia tag nrho cov PPCs uas cuam tshuam nrog kev thov rau Medicaid (Medi-Cal hauv California) cov nyiaj them lossis nrog cov kev kho mob uas tau muab rau cov neeg mob uas yuav muaj Medicaid. Tsoom Fwv Teb Chaws cov cai thiab lub xeev txoj cai tseem txwv tsis pub Medicaid them rau kev kho mob ntawm PPCs.​​ 

Muaj ob hom PPCs: Cov kev kho mob tau txais kev kho mob (HCAC), uas yuav tsum tau tshaj tawm yog tias cov no tshwm sim hauv tsev kho mob mob hnyav, thiab lwm yam kev tiv thaiv kev tiv thaiv (OPPC), uas yuav tsum tau tshaj tawm yog tias qhov no tshwm sim hauv ib qho chaw kho mob.​​ 

HCACs yog tib yam li cov mob hauv tsev kho mob tau txais (HACs) uas tuaj yeem tshaj tawm rau Medicare, tshwj tsis yog tias Medi-Cal tsis xav kom cov kws kho mob qhia txog cov hlab ntsha sib sib zog nqus / pulmonary embolism rau cov poj niam cev xeeb tub thiab cov menyuam yaus hnub nyoog qis dua 21 xyoo, raws li tau sau tseg hauv qab no.

Cov lej ICD-10-CM rau HCACs muaj nyob rau ntawm CMS lub vev xaib rau "ICD-10 HAC List."

Cov kws kho mob yuav tsum tau tshaj tawm HCACs tsuas yog thaum lawv tshwm sim hauv tsev kho mob mob hnyav.​​ 

HCACs:
　• Air embolism
　• Ntshav incompatibility
　• Catheter-associated urinary tract infection
　• Deep vein thrombosis/pulmonary embolism (tsis suav cov poj niam cev xeeb tub thiab cov menyuam yaus hnub nyoog qis dua 21 xyoos)
　cphuma tom qab ntawd: Fumocracure
　　 
　 　 o Dislocation
　 　 o Intracranial raug mob
　 　 o Crushing raug mob
　 　 o Hlav
　 　 o Hluav taws xob poob siab
　• Cov khoom txawv teb chaws khaws cia tom qab phais
　• Iatrogenic pneumothorax nrog venous catheterization
　kev tswj tsis zoo
　 　 ketoacidosis
　 　 o Nonketotic hyperosmolar coma
　 　 o Hypoglycemic coma
　 　 o Secondary diabetes with ketoacidosis
　 　 o Secondary diabetes with hyperosmolarity
　• Theem III or IV pressure ulcers
　• Kev mob ntshav qab zib mob ntshav qab zib
　 　 graft (CABG)
　 　 o Surgical site infections nram qab no:
　　 　　　 • Bariatric surgery
　　　　　　 　　 • Laparoscopic gastric bypass
　　　　　　 　　 • Gastroenterostomy
　　　　　 　　　 • Laparoscopic gastric restrict surgery
　　 　　 • Orthopedic cov txheej txheem rau txha nraub qaum, caj dab, lub xub pwg nyom thiab hluav taws xob
(CIED) cov txheej txheem
　• Vascular catheter-associated infection​​ 

OPPCs kuj tseem hu ua "tsis muaj xwm txheej" thiab Cov Txheej Txheem Tshaj Tawm Loj nyob hauv Medicare. Rau Medi-Cal, OPPCs tau txhais raws li hauv qab no:
• Kev phais tsis raug/tus txheej txheem invasive
• Kev phais/kev phais ua rau tus neeg mob tsis raug cai
• Kev phais/kev phais ua rau ntawm lub cev tsis raug​​ 

 

Cov kws kho mob yuav tsum ceeb toom peb cov OPPCs no thaum cov no tshwm sim hauv ib qho chaw kho mob. "Invasive Procedure" yog hais txog kev phais.​​