Title: Coding Creatinine
Scenario: A patient scheduled for hip replacement surgery on Friday 2/7 presents to the ER on
Wednesday 2/5 with c/o chest pain. Assessment reveals negative biomarkers and
unremarkable ECG, however in light of the patient’s symptoms and impending surgery the
patient is taken to the cath lab for further evaluation. Coronary angiography shows an 80% LAD
lesion with FFR ratio of 0.76, PCI proceeds with stent placement. Labs obtained prior to arrival
are available as well as labs obtained in the ER, specifically the outpatient creatinine lab
obtained Monday 2/3 was 1.43 while the ER creatinine lab pre-procedure was 1.24. Postprocedure the highest creatinine was 1.58
Question: Which pre-procedure creatinine should be coded?
Answer: To meet the target value for Seq#7315 (Pre-Procedure Creatinine), capture the LAST
(most recent) value between 1 month prior to arrival and the current procedure. In this case,
1.24 would be used.
Additional Information: Each lab result is coded to the tenth place value, results are not rounded. The
results would be coded as 1.2 for pre-procedure creatinine and 1.5 for the post-procedure value.
Rationale: Currently the NCDR captures the creatinine lab value to the tenth place as identified
in the Technical Specifications included in the Data Dictionary Full Specification. Values are
NOT rounded, but are coded to the tenth place value.