Table 1.

Coding algorithm for selected oncology‐specific triggers

Trigger	Coding algorithm*
General care
Pressure ulcer	ICD9 707.x (exclude 707.21 and 707.22)
Return to the operating room or interventional radiology within 30 d of surgery	See Osborne NH, et al
Vital signs
Low oximetry results (SaO2 < 88%)	ICD9 799.02
Fever (> 38.2°C)	ICD9 780.6 and ICD9 288.x
Orders
Blood transfusion	ICD9 V58.2, CPT 36 430
Contact precautions/order for isolation	ICD9 V07.x
Nasogastric tube (not in operating room)	ICD9 96.07, CPT 43 753
Non‐contrast chest CT after radiation to the chest	CPT 71 250
Percutaneous drain placement	ICD9 54.91, CPT 32 557
Laboratories
Abnormal serum bicarbonate (< 18,> 36 mEq/L)	ICD9 790.6, 276.2, 276.3
Abnormal serum potassium (> 6, < 2.5 mEqL)	ICD9 276.8, 276.7
Clostridium difficile toxin positive	ICD9 008.45
Elevated creatinine > 1 mg/dL and 50% greater than baseline	ICD9 584.9 acute kidney injury (not present on admission)
Positive blood culture without contaminant	ICD9 790.7 bacteremia, CPT 87 040, 87 103
Medication‐related
Initiation of therapeutic anticoagulation	medications: warfarin, enoxaparin, apixaban, rivaroxaban, dabigatran, fondaparinux, edoxaban
Consultations
Nephrology consultation	E&M visit (outpatient CPT 99241‐99245, inpatient CPT 99251‐99255) and provider_specialty = ‘nephrologist’

Osborne NH, Nicholas LH, Ryan AM, Thumma JR, Dimick JB. Association of hospital participation in a quality reporting program with surgical outcomes and expenditures for Medicare beneficiaries. JAMA 2015; 313:496‐504.

Abbreviations: CPT, Current Procedure Terminology; CT, computed tomography; ICD, International Classification of Diseases.

^*ICD9 codes mapped to ICD10