Here is the question that we submitted and the response that we received from CMS:
If Covid-19 or Covid-19 suspect are in the final discharge diagnosis, do patients excluded from the Sep-1 bundle (since it is a viral infection)? Thank you for your question. You would disregard documentation of a viral infection and continue abstraction per the guidance in manual v5.7. Cases would only be excluded from the measure if they didn't meet the severe sepsis present data element or if severe sepsis was documented as due to a viral infection within 6 hours after the severe sepsis presentation time. We are not expecting any additional guidance to be added to manual v5.7 related to COVID-19 cases since CMS is no longer requiring submission of 1st or 2nd quarter cases. Manual v5.8 was recently updated with the below guidance, which will be used in abstraction of July 1 – December 31, 2020 discharges. Severe Sepsis Present – Manual v5.8 - Select Value "2" if there is physician/APN/PA documentation that coronavirus or COVID-19 is suspected or present. Beth Beth Knight, BSN, RN, OCN Clinical Quality Specialist II Healthcare Quality Franciscan Health Indianapolis, Carmel, Mooresville Sierra Building 1040 Sierra Drive Suite 1900 Greenwood, IN 46143 Work Phone: 317-528-1470 Cell Phone: 317-965-0430 [email protected]<mailto:[email protected]> CONFIDENTIALITY NOTICE: The information contained in this email and any accompanying documents is intended for the sole use of the recipient to whom it is addressed, and may contain information that is privileged, confidential, and prohibited from disclosure under applicable law. If you are not the intended recipient, or authorized to receive this on behalf of the recipient, you are hereby notified that any review, use disclosure, copying, or distribution is prohibited. If you are not the intended recipient(s), please contact the sender by email and destroy all copies of the original message. Thank You. • Please don't print this e-mail unless you really need to. From: Sepsisgroups <[email protected]> On Behalf Of Roney, Jamie K Sent: Thursday, June 11, 2020 11:29 AM To: Deffenbaugh, Amy M <[email protected]>; Merwin, Courtney C. <[email protected]>; '[email protected]' <[email protected]> Subject: Re: [Sepsis Groups] [EXTERNAL] Re: Sepsis & COVID WARNING: This email is from an EXTERNAL source. Exercise caution. • Do not click on any links or attachments unless you are certain that they are safe and are required for business. • If you believe this is a suspicious email click the Phish Alert button in the toolbar to have it removed, or if you are on a mobile device just delete the email. (o365) Good morning, Any organism, whether viral, fungal, parasitic, bacterial, etc., has always had the possibility of triggering the systemic sepsis response and has never changed the treatment recommendations of EGDT by experts. Viral infection is not an exclusionary criteria for abstraction and both co-owners of the CMS Sepsis Core Measure are a part of this forum (one being Dr. Rivers who introduced us to EGDT), thus I should not speak for them. Known bacterial infection or not does not impact our treatment or abstraction of these patients. Respectfully, Dr. Roney Jamie Roney, DNP, RN, BSHCM, NPD-BC, CCRN-K Regional sepsis coordinator/Nursing Professional Development Specialist IV "Be a yardstick of quality. Some people aren't used to an environment where excellence is expected." ~Steve Jobs 3615 19th Street, Lubbock, TX 79410 T: (806) 725-4689 C: (806) 773-1914 www.covenanthealth.org<https://nam01.safelinks.protection.outlook.com/?url=https%3A%2F%2Furldefense.proofpoint.com%2Fv2%2Furl%3Fu%3Dhttps-3A__nam02.safelinks.protection.outlook.com_-3Furl-3Dhttp-253A-252F-252Fwww.covenanthealth.org-252F-26data-3D02-257C01-257CJoAnn.Long-2540LCU.EDU-257Cce910366f32840fc35e908d73d0fec92-257Cac351d2dd6fe47c8a15c3c4900d9da18-257C0-257C0-257C637045011227045827-26sdata-3D5zjfS8-252FEVUuhOhFVOm2-252BBClDRJEassSzhdsHyuyxPn8-253D-26reserved-3D0%26d%3DDwMFAg%26c%3DKoC5GYBOIefzxGAm2j6cjFf-Gz7ANghQIP9aFG9DuBs%26r%3DioyVXu84Fgh_cDFmAFc7ayo1-asuRRLLvGo0Fvxncu0%26m%3DhtkFFPsTgs4sGyNR35TyV004FARHmP_o5n3BmkVpbpg%26s%3DPeFB1vLqSAu7_726-NHoqF-pNxiwF4WqChZ_w-QGsSA%26e%3D&data=01%7C01%7Celizabeth.knight%40franciscanalliance.org%7C4b4971112f41453946a108d81216f8fa%7C4b843c54adae4ff29f04d9248f52101e%7C0&sdata=j5zDgudXZqqeQMNWsg09Uis851TakQUPS31g9ggL26g%3D&reserved=0> ………………………………………………………………………….. [cid:[email protected]][socialicons.jpg]<https://nam01.safelinks.protection.outlook.com/?url=https%3A%2F%2Furldefense.proofpoint.com%2Fv2%2Furl%3Fu%3Dhttps-3A__nam02.safelinks.protection.outlook.com_-3Furl-3Dhttp-253A-252F-252Fwww.facebook.com-252FCovenantHealth-26data-3D02-257C01-257CJoAnn.Long-2540LCU.EDU-257Cce910366f32840fc35e908d73d0fec92-257Cac351d2dd6fe47c8a15c3c4900d9da18-257C0-257C0-257C637045011227050811-26sdata-3DAKnGxKCjGEo47IjljUBJD5ZLVl4JjpKWI0xADqay-252B1A-253D-26reserved-3D0%26d%3DDwMFAg%26c%3DKoC5GYBOIefzxGAm2j6cjFf-Gz7ANghQIP9aFG9DuBs%26r%3DioyVXu84Fgh_cDFmAFc7ayo1-asuRRLLvGo0Fvxncu0%26m%3DhtkFFPsTgs4sGyNR35TyV004FARHmP_o5n3BmkVpbpg%26s%3Ddl_8-DKmRtlgkvuU5cpOl8i-GfKu2nhUuOIO3WXqBQs%26e%3D&data=01%7C01%7Celizabeth.knight%40franciscanalliance.org%7C4b4971112f41453946a108d81216f8fa%7C4b843c54adae4ff29f04d9248f52101e%7C0&sdata=%2BO8fvC7IunkjZUGDGiuRsC9E0SkS2CqlmlEpVUshAWo%3D&reserved=0> [socialicons.jpg] <https://nam01.safelinks.protection.outlook.com/?url=https%3A%2F%2Furldefense.proofpoint.com%2Fv2%2Furl%3Fu%3Dhttps-3A__nam02.safelinks.protection.outlook.com_-3Furl-3Dhttp-253A-252F-252Ftwitter.com-252F-2523-21-252F-2540covhs-26data-3D02-257C01-257CJoAnn.Long-2540LCU.EDU-257Cce910366f32840fc35e908d73d0fec92-257Cac351d2dd6fe47c8a15c3c4900d9da18-257C0-257C0-257C637045011227055800-26sdata-3DSnyH3ZbJ31JSYCUVZXQqNoQwPQatVBcVJoOcTsl7KPQ-253D-26reserved-3D0%26d%3DDwMFAg%26c%3DKoC5GYBOIefzxGAm2j6cjFf-Gz7ANghQIP9aFG9DuBs%26r%3DioyVXu84Fgh_cDFmAFc7ayo1-asuRRLLvGo0Fvxncu0%26m%3DhtkFFPsTgs4sGyNR35TyV004FARHmP_o5n3BmkVpbpg%26s%3D0CBzMEaboXAleKkOg7X5GAcVr9YmOajETdzD2WSB37w%26e%3D&data=01%7C01%7Celizabeth.knight%40franciscanalliance.org%7C4b4971112f41453946a108d81216f8fa%7C4b843c54adae4ff29f04d9248f52101e%7C0&sdata=ILyb%2BMSmoaILXIEydteXt%2F5LxyHUj0KK7sTOVimL1Jw%3D&reserved=0> [socialicons.jpg] <https://nam01.safelinks.protection.outlook.com/?url=https%3A%2F%2Furldefense.proofpoint.com%2Fv2%2Furl%3Fu%3Dhttps-3A__nam02.safelinks.protection.outlook.com_-3Furl-3Dhttp-253A-252F-252Fwww.everymomentmatters.org-252F-26data-3D02-257C01-257CJoAnn.Long-2540LCU.EDU-257Cce910366f32840fc35e908d73d0fec92-257Cac351d2dd6fe47c8a15c3c4900d9da18-257C0-257C0-257C637045011227060791-26sdata-3DCHaguE7O8L6SRHTCi23I84zr077bXGcdDxOfS5pxU3M-253D-26reserved-3D0%26d%3DDwMFAg%26c%3DKoC5GYBOIefzxGAm2j6cjFf-Gz7ANghQIP9aFG9DuBs%26r%3DioyVXu84Fgh_cDFmAFc7ayo1-asuRRLLvGo0Fvxncu0%26m%3DhtkFFPsTgs4sGyNR35TyV004FARHmP_o5n3BmkVpbpg%26s%3DI6QpHLdY66G8axgxIdSXebJLaH5H3sKLYZi8kXRdzyM%26e%3D&data=01%7C01%7Celizabeth.knight%40franciscanalliance.org%7C4b4971112f41453946a108d81216f8fa%7C4b843c54adae4ff29f04d9248f52101e%7C0&sdata=7yGqkOrudsaBptbM03Gsuga%2Fswu969c0Ua8AQS0%2FTnA%3D&reserved=0> [cid:[email protected]] From: Sepsisgroups [mailto:[email protected]] On Behalf Of Deffenbaugh, Amy M Sent: Tuesday, June 9, 2020 5:07 AM To: Merwin, Courtney C. <[email protected]<mailto:[email protected]>>; '[email protected]' <[email protected]<mailto:[email protected]>> Subject: [EXTERNAL] Re: [Sepsis Groups] Sepsis & COVID In my opinion, even if there is septic shock, if your source is viral, you still do not have to abstract. If there is a “possible superimposed bacterial infection” being treated with antibiotics, you would have to abstract. And check your documentation within 6 hours to rule out infection and 24 hours for rule out of SIRS and organ dysfunction Amy M Deffenbaugh RN, BSN Quality Improvement Coordinator St Rita’s Medical Center 730 W Market St Lima, OH 45801 Phone (419) 996-5513 Fax ( 419) 226-9180 [email protected]<mailto:[email protected]> From: Sepsisgroups <[email protected]<mailto:[email protected]>> On Behalf Of Merwin, Courtney C. Sent: Thursday, May 14, 2020 11:49 AM To: '[email protected]' <[email protected]<mailto:[email protected]>> Subject: [Sepsis Groups] Sepsis & COVID How are you handling abstractions for Sepsis with COVID? Clearly infection is suspected to be viral including documentation of such. But when a physician documents septic shock, does that have to be abstracted as Severe sepsis presentation? What about when there is documentation of antibiotics ordered for “possible superimposed bacterial infection”? Courtney Merwin BS, RRT, CPHQ Clinical Quality Analyst East Jefferson General Hospital 4200 Houma Blvd. Metairie, LA 70006 504-503-5968 [email protected]<mailto:[email protected]> ________________________________ IMPORTANT NOTICE: This message and any included attachments are from East Jefferson General Hospital or its Affiliates, is for the intended addressee(s)only, and may include Protected Health (PHI) or other confidential information. If you are the intended recipient, you are obligated to maintain it in a secure and confidential manner and re-disclosure without additional consent or as permitted by law is prohibited. If you are not the intended recipient, use of this information is strictly prohibited and may be unlawful. Please promptly reply to the sender by email and delete this message from your computer. 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