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C. diff infection from animals?

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southerndoc

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BADMD

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southerndoc

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http://whitecoatrants.wordpress.com/2008/11/18/woohoo-free-hamburgers/

Whitecoat wrote about this yesterday.

But don't worry, it is still your fault and CMS won't pay for it.
Speaking of being our fault and CMS not paying...

I recently admitted an elderly woman with UTI/sepsis. She was admitted 2 weeks prior for pneumonia/sepsis and although I didn't find documentation to such, one could think that she had a Foley catheter during her stay because of her sepsis.

She presented with altered mentation, and a urinalysis showed a UTI (which later grew Enterococcus). Her creatinine went from 0.8 to 2.5, and her lactic acid was positive at 4.

Gave her the bug juice and admitted her.

I wonder if the hospital gets paid for this? Would this be considered a never event because she had a Foley on a prior hospitalization, or could has some time limit lapsed where the two cannot be connected?
 

BADMD

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Good question. I dunno.

The specific rule excludes the ICD-9 code for "Infection and inflammatory reaction due to indwelling urinary catheter." So maybe it has something to do with what code gets assigned.

Diagnosis it as a catheter associated UTI --> Don't get paid
Diagnosis it as an enterococcus related UTI --> Get paid

I feel a new fraud focus coming....
 

BADMD

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I just pulled up a few papers and they all defined it as occurring while the patient had the catheter in and was in the hospital...
 

Jeff698

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My first thought when I read this thread title was "what the hell is Southern doing with animals, now?".

Apparently, that wasn't the point at all.

Take care,
Jeff
 

Jeff698

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Texas. Where the men are men and sheep are nervous.

How was your date last night? Not baaaaad.

For some strange reason, growing up in Texas seems to expose one to all sorts of iterations of this theme.

Hmmmmm....

Take care,
Jeff
 
D

deleted65604

In med school, a family medicine attending told the following joke in a lecture to our entire class in physical diagnosis:

A city-slicker wanted some time away from the hustle and bustle of city life. He signed on to herd sheep for a summer. The previous shepherd is teaching him the ropes and mentions, “and if you ever get bored, just have your way with the sheep, we all do it.” The city-slicker is disgusted, but as the months go by, he becomes rather lonely and decides to give it a try.

The summer ends and he is giving report to the shepherd whose advice he had taken. He informs the shepherd that he gave it a try and wasn’t that bad. The shepherd asks him which sheep he had used, and he points to the victim, at which time, the shepherd falls on the ground in peels of laughter.

The city-slicker is mortified, fearing that the shepherd would spread the tale of the sheep-loving city-slicker far and wide. He asks, “So, you haven’t ever fornicated with a sheep before I take it?” The shepherd, hardly able to talk through his laughter stutters…”You picked the ugliest one!”

Come to think of it, I think my attending was from Texas. Maybe it was a autobiographical joke?
 
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