Unplanned/unexpected readmissions are those readmissions where the principal diagnosis indicates an adverse event.
Principal diagnoses codes
A principal diagnosis for the readmission has one of the following ICD-10-AM (6th Ed) codes: T80–88, T98.3, E89, G97, H59, H95, I97, J95, K91, M96 or N99.
T80 Complications following infusion, transfusion and therapeutic injection
T81 Complications of procedures, not elsewhere classified
T82 Complications of cardiac and vascular prosthetic devices, implants and grafts
T83 Complications of genitourinary prosthetic devices, implants and grafts
T84 Complications of internal orthopaedic prosthetic devices, implants and grafts
T85 Complications of other internal prosthetic devices, implants and grafts
T86 Failure and rejection of transplanted organs and tissues
T87 Complications peculiar to reattachment and amputation
T88 Other complications of surgical and medical care, not elsewhere classified
T98.3 Sequelae of complications of surgical and medical care, not elsewhere classified
E89 Postprocedural endocrine and metabolic disorders, not elsewhere classified
G97 Postprocedural disorders of nervous system, not elsewhere classified
H59 Postprocedural disorders of eye and adnexa, not elsewhere classified
H95 Postprocedural disorders of ear and mastoid process, not elsewhere classified
I97 Postprocedural disorders of circulatory system, not elsewhere classified
J95 Postprocedural respiratory disorders, not elsewhere classified
K91 Postprocedural disorders of digestive system, not elsewhere classified
M96 Postprocedural musculoskeletal disorders, not elsewhere classified
N99 Postprocedural disorders of genitourinary system, not elsewhere classified
Procedure codes
Number of separations in which one of the following surgical procedures was undertaken: knee replacement; hip replacement; tonsillectomy and adenoidectomy; hysterectomy; prostatectomy; cataract surgery; appendicectomy.
The following is a list of the specific ACHI (6th Ed) procedure codes which are included in the specifications for each of the selected surgical procedures.
Procedure
Procedure Codes
Description
Knee replacement
49518-00
Total arthroplasty of knee, unilateral
49519-00
Total arthroplasty of knee, bilateral
49521-02
Total arthroplasty of knee with bone graft to tibia, unilateral
Hip replacement
49318-00
Total arthroplasty of hip, unilateral
49319-00
Total arthroplasty of hip, bilateral
Tonsillectomy and adenoidectomy
41789-00
Tonsillectomy without adenoidectomy
41789-01
Tonsillectomy with adenoidectomy
41801-00
Adenoidectomy without tonsillectomy
Hysterectomy
35653-01
Total abdominal hysterectomy
35653-04
Total abdominal hysterectomy with removal of adnexa
35661-00
Abdominal hysterectomy with extensive retroperitoneal dissection
35670-00
Abdominal hysterectomy with radical excision of pelvic lymph nodes
35756-00
Laparoscopically assisted vaginal hysterectomy proceeding to abdominal hysterectomy
35756-03
Laparoscopically assisted vaginal hysterectomy proceeding to abdominal hysterectomy with removal of adnexa
90448-01
Total laparoscopic abdominal hysterectomy
90448-02
Total laparoscopic abdominal hysterectomy with removal of adnexa
35657-00
Vaginal hysterectomy
35673-02
Vaginal hysterectomy with removal of adnexa
35667-00
Radical abdominal hysterectomy
35664-00
Radical abdominal hysterectomy with radical excision of pelvic lymph nodes
35664-01
Radical vaginal hysterectomy with radical excision of pelvic lymph nodes
35667-01
Radical vaginal hysterectomy
90443-00
Other excision of uterus
Prostatectomy
37207-00
Endoscopic laser ablation of prostate (includes TULIP)
37201-00
Transurethral needle ablation of prostate
37203-00
Transurethral resection of prostate
37203-02
Transurethral electrical vaporisation of prostate
37203-04
Microwave thermotherapy of prostate
37203-05
High intensity focussed ultrasound (transrectal) of prostate
37207-01
Endoscopic laser excision of prostate
37200-03
Suprapubic prostatectomy
37200-04
Retropubic prostatectomy
37224-00
Endoscopic destruction of prostatic lesion
37224-01
Endoscopic resection of prostatic lesion
90407-00
Excision of other lesion of prostate
37203-03
Cryoablation of prostate
Cataract surgery
42698-00
Intracapsular extraction of crystalline lens
42702-00
Intracapsular extraction of crystalline lens with insertion of foldable artificial lens
42702-01
Intracapsular extraction of crystalline lens with insertion of other artificial lens
42698-01
Extracapsular extraction of crystalline lens by simple aspiration (and irrigation) technique
42702-02
Extracapsular extraction of crystalline lens by simple aspiration (and irrigation) technique with insertion of foldable artificial lens
42702-03
Extracapsular extraction of crystalline lens by simple aspiration (and irrigation) technique with insertion of other artificial lens
42698-02
Extracapsular extraction of crystalline lens by phacoemulsification and aspiration of cataract
42702-04
Extracapsular extraction of crystalline lens by phacoemulsification and aspiration of cataract with insertion of foldable artificial lens
42702-05
Extracapsular extraction of crystalline lens by phacoemulsification and aspiration of cataract with insertion of other artificial lens
42698-03
Extracapsular crystalline lens extraction by mechanical phacofragmentation and aspiration of cataract
42702-06
Extracapsular crystalline lens extraction by mechanical phacofragmentation and aspiration of cataract with insertion of foldable artificial lens
42702-07
Extracapsular crystalline lens extraction by mechanical phacofragmentation and aspiration of cataract with insertion of other artificial lens
42698-04
Other extracapsular extraction of crystalline lens
42702-08
Other extracapsular extraction of crystalline lens with insertion of foldable artificial lens
42702-09
Other extracapsular extraction of crystalline lens with insertion of other artificial lens
42731-01
Extraction of crystalline lens by posterior chamber sclerotomy with removal of vitreous
42698-05
Other extraction of crystalline lens
42702-10
Other extraction of crystalline lens with insertion of foldable artificial lens
42702-11
Other extraction of crystalline lens with insertion of other artificial lens
Appendicectomy
30571-00
Appendicectomy
30572-00
Laparoscopic appendicectomy
Limited to public hospitals.
Denominator limited to separations with a separation date between 1 July and 19 May in the reference year.
Denominator excludes separations where the patient died in hospital.
Analysis by state and territory is based on location of service.
Analysis by remoteness and SEIFA Index of Relative Socioeconomic Disadvantage (IRSD) is based on usual residence of person.
Presented per 1,000 separations.
Computation:
1,000 x (Numerator ÷ Denominator)
Calculated separately for each of the specified procedures
Numerator:
Number of separations for public hospitals which meet all of the following criteria:
The separation is a readmission to the same hospital following a separation in which one of the following procedures was performed: knee replacement; hip replacement; tonsillectomy and adenoidectomy; hysterectomy; prostatectomy; cataract surgery; appendicectomy (see procedure codes in computation description field)
The readmission occurs within 28 days of the previous date of separation
A principal diagnosis for the readmission has one of the following ICD10-AM codes: T80–88, T98.3, E89, G97, H59, H95, I97, J95, K91, M96 or N99
Numerator data elements:
Denominator:
Number of separations in which one of the following surgical procedures was undertaken: knee replacement; hip replacement; tonsillectomy and adenoidectomy; hysterectomy; prostatectomy; cataract surgery; appendicectomy.
Denominator data elements:
Disaggregation:
2009–10—Nationally, by specified procedures by SEIFA Index of Relative Socioeconomic Disadvantage (IRSD) deciles
2009–10—State and territory, by specified procedures, by:
peer group
Indigenous status
remoteness (Australian Standard Geographical Classification Remoteness Structure)
SEIFA IRSD quintiles
Some disaggregations may result in numbers too small for publication. National disaggregation by Indigenous status will be based on data only from jurisdictions for which the quality of Indigenous identification is considered acceptable.
Disaggregation data elements:
Comments:
Most recent data available for 2012 CRC report: 2009–10
The scope of the National Hospital Morbidity Database (NHMD) is episodes of care for admitted patients in essentially all hospitals in Australia, including public and private acute and psychiatric hospitals, free-standing day hospital facilities, alcohol and drug treatment hospitals and dental hospitals.
The title of this indicator was changed in the 2012 NHISSC specifications from Unplanned/unexpected readmissions within 28 days of selected surgical admissions to Unplanned/unexpected readmissions within 28 days of selected surgical episodes of care to better reflect how the indicator is calculated. Readmissions for this indicator are defined within 28 days from the end of the patient’s surgical episode of care.
