VNS Health Research Leads To New Diagnostic Code, Aiding Post-Acute Care Providers 

The Centers for Disease Control and Prevention (CDC) added a new diagnostic code to their annual update of the International Classification of Diseases (ICD-10) list. The new code, z512A, supports providers in hospitals and health facilities by alerting home care clinicians and other post-acute care providers when a patient is being discharged to aftercare following hospitalization for sepsis.

The need for a new ICD-10 code for sepsis survivors was spurred by findings from a VNS Health study showing that sepsis was noted in admission assessments only 7% of the time. This caused researchers to question whether home health providers were aware that a patient had been diagnosed with sepsis. The study also identified the risk factors associated with early readmission of sepsis survivors.

“Having an ICD-10 code for sepsis aftercare lets providers know when a patient discharged to them is a sepsis survivor,” Dr. Kathryn H. Bowles, director of the VNS Health Center for Home Care Policy & Research, told Home Health Care News. “When people are hospitalized for sepsis, they are not discharged until the illness is resolved. When sepsis is resolved, it falls to the patient’s history and may not be included in the current problem list communicated during the transition to post-acute care.”

VNS Health provides home, hospice, and personal and private care services in New York. The Center for Home Care Policy & Research conducts research to support home- and community-based services and inform decision-making providers, policymakers and consumers.

“Because sepsis has a high readmission rate mainly due to recurrence, any patient who has had sepsis is at risk, and many suffer a long recovery dealing with the after-effects of sepsis,” Bowles continued. “Research showed timely attention the first week after sepsis discharge effectively decreases 30-day readmissions. If the next level of care doesn’t know the patient is a sepsis survivor, providers cannot activate effective protocols for prevention. The new code will alert the next level of care.”

An ongoing study by the same research team revealed the lack of a diagnostic code to identify sepsis survivors after discharge. Home health personnel explained that because sepsis is an acute care condition treated and resolved in the hospital, they cannot place it on the home care record. The study provided evidence that because of this communication gap, home care providers and clinicians may not be prompted to give the attention and close monitoring that sepsis recovery warrants.

“As our team discovered, there was a serious communication gap between hospitals and post-acute care providers when it came to caring for sepsis survivors,” Bowles said. “Without knowing an incoming patient had recently survived sepsis, home care providers were missing an important piece of the puzzle in determining a plan of care. Because there was no aftercare code, sepsis survivors were being coded as having pneumonia or urinary tract infection, or ‘other aftercare.’ However, as we know, knowledge is power, and with this code, home care teams and patients are empowered. They can provide the necessary care to avoid a recurrence of sepsis and preventable hospitalizations or death.”

Following the publication of these findings, the research team led an advocacy effort to persuade the CDC to adopt a diagnostic code defining sepsis aftercare as a separate condition. The new code was accepted and announced in July and took effect Oct. 1.

“Knowing the patient is a sepsis survivor alerts the team to activate evidence-based protocols for timely start of care and outpatient follow-up, close surveillance, antibiotic stewardship and patient teaching,” Bowels explained. “Sepsis strikes fast, so patients and caregivers must be educated to monitor their temperature, take their medications as prescribed and call their home care providers immediately if they feel worse.”