Penn Nursing Research Leads to New ICD Code for Sepsis Survivors
Starting today, the Centers for Disease Control and Prevention (CDC) is adding an important new diagnostic code to their annual update of the International Classification of Diseases (ICD-10) list. The new “Encounter for Sepsis Aftercare” update came about as the result of ground-breaking research from a collaboration between Penn Nursing and the Center for Home Care Policy & Research at VNS Health. The new code, z51A, supports providers in hospitals and health facilities nationwide by alerting home care clinicians and other post-acute care providers when a patient is being discharged to aftercare following hospitalization for sepsis, a life-threatening medical condition triggered by an extreme response to infection.
October 01, 2024
The need for a new ICD-10 code for sepsis survivors was spurred by findings from a VNS Health study where analysis of the records of over 165,000 sepsis survivors entering home care showed that sepsis was noted in admission assessments only 7% of the time. This alarming discovery caused the researchers to question whether home health providers were even aware that a patient had been diagnosed with sepsis. This study also identified risk factors associated with early readmission of sepsis survivors. The study, led by Kathryn H. Bowles, PhD, RN, FAAN, FACMI, the van Ameringen Chair in Nursing Excellence, Professor of Nursing in the Department of Biobehavioral Health Sciences, and the Director of the VNS Health Center for Home Care Policy & Research, was published in the Journal of the American Medical Directors Association, in 2020.
“Our work has shown that timely attention by home care and outpatient clinicians is highly effective for sepsis survivors. It is critically important to communicate sepsis survivorship across transitions in care because among those readmitted from home health care, one-third occur in the first seven days.” Said Bowles. “We are hopeful this new ICD code will direct the necessary attention to sepsis survivors and improve outcomes for the 1.7 million Americans who encounter sepsis each year.”
In an ongoing NIH funded study (R01NR016014) also led by Bowles with VNS Health colleagues, interviews with personnel at 16 hospitals and five affiliated home health agencies across the U.S. 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 are not able to 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 provide the timely attention and close monitoring that sepsis recovery warrants. Between one-third and one-half of readmissions are due to sepsis recurrence and up to 50% of sepsis survivors are left with long-term physical and/or psychological effects. It is critical that post-acute care clinicians are aware they are caring for a sepsis survivor.
Following publication of these research findings, Bowles and her team led a coordinated advocacy effort aimed at persuading the CDC of the need for a diagnostic code that defines sepsis aftercare as a separate condition. After a formal presentation by the team to a CDC committee in March of 2023, a new ICD-10 code was accepted and announced in July of this year. The code takes effect October 1, 2024.
