No documented Comorbid/Complications in relevant admissions: Comorbid/Complication 1 is 00000 AND Comorbid/Complication 2 - 10 are blank
No documented Comorbid Complications in relevant Secondary Diagnosis Document: Comorbid/Complication 1-10 are all blanks.
Documented Comorbid/Complications: One or more non-blank, non-00000, allowable codes entered.
Relevant source document hierarchy: An ordered list of selected relevant source documents that provides the means to determine the precedence data from one source document should have over another in consolidation decisions. Here we are using class of case, date of 1st contact if necessary, and then admission ID as a last resort to determine the hierarchy.
Distinct known codes: No duplicate codes, 00000, or blanks

Triggers

The set of relevant source documents linked to the tumor changed
Class of Case, Date of 1st Contact, or one or more Comorbid/Complication fields are changed in a relevant source document
Special global re-consolidation processes

Process

1. If either of the following conditions is true:

All relevant source documents have no documented Comorbid/Complications
Relevant admissions have no documented Comorbid/Complications and there is no relevant Secondary Diagnosis Document available

Then set:

Comorbid/Complication 1 – 10 to not documented
Source Comorbidity to 0
ICD Revision Comorbid to 0

And stop here.

2. If both of the following conditions are true:

Relevant admissions have no documented Comorbid/Complications
Relevant Secondary Diagnosis Document available with documented Comorbid/Complications

Then set:

Comorbid/Complication 1 – 10 fields with distinct known codes from SDX until all fields are filled or distinct known codes are exhausted
Source Comorbidity to 2
ICD Revision Comorbid to 9

And stop here.

3. Otherwise, determine the relevant source document hierarchy by selecting only relevant admissions with documented Comorbid/Complications and ignoring relevant Secondary Diagnosis Document:

Compare the selected admissions’ class of case values. Use the Class of Case hierarchy below to determine an initial relevant source document hierarchy with 00 being highest:

00
10 – 14
34
20 – 22
36
40 – 41
30 – 33
38
35, 37
42 – 49
99

If there is more than one selected admission with a class of case in any of the above ranges, then attempt to refine the sub-hierarchies by ordering each range set by Date of 1st Contact (earliest is highest), accounting for missing or partial dates in the comparisons. We can determine whether or not one date is earlier than the other if

the two dates have known but different years,
the two dates have the same known year but different known months, or
the two dates have the same known year & month but different known days

We can only use this method to set the sub-hierarchy for each class of case range set if the earlier/later determination can be made for all dates in the range set.

If there is more than one selected admission in any of the class of case ranges and a sub-hierarchy for a range set could not be determined using Date of 1st Contact, then set the sub-hierarchy for it using Admission ID (lowest number is highest in the sub-hierarchy).

4. Then set:

Comorbid/Complication 1 – 10 fields with distinct known codes from the selected admissions following the relevant source document hierarchy from highest to lowest until all fields are filled or all selected admissions are exhausted
Source Comorbidity to 1
ICD Revision Comorbid to 9

And stop here.

Manual Change

Not allowed

Admission Level

Manual Change or Correction Applied to Comorbid/Complication 1 – 10, Source Comorbidity, or ICD Revision Comorbid.

Perform automatic QC procedures described under SOURCE

historical changes

04/2014

New Multi-Document Update Logic implemented.