Case / Outcomes Tab

Overview

The Outcomes tab is used to add, edit, or remove outcomes on a case. An outcome describes the result of a given procedure, or a situation or condition observed prior to, during, or after a procedure. Outcomes are stored at the case level and can be removed or replaced at any time. Outcome values attached to a case are also sent with applicable AQI files.

How to Get Here?

From the Home Page:	From the Menus:	*Via Shortcut Keys:*
Click Charge Batches from the Manage list. Double-click the charge batch to review. Double-click the case to review. Click the Outcomes tab.	Open the Manage menu and select Charge Batches. Double-click the charge batch to review. Double-click the case to review. Click the Outcomes tab.	Press [Alt] + [M] + [C]. Double-click the charge batch to review. Double-click the case to review. Press [Alt] + 6 to navigate to the Outcomes tab.

Field Definitions

Field

Type

Required

Description

Outcome

Display Only

(pulled from added/edited Outcome)

Yes

The name of the outcome.

Type

Display Only

(pulled from selected Outcome)

Yes

The level of impact the outcome has on the case.

Outcome values are attached to specified Type designations. Type indicates the impact the outcome has on the case, including:

Impact	Examples
Major Adverse Event	Unplanned ICU admission, permanent organ system injury, epidural hematoma, etc.
Minor Adverse Event	Postoperative nausea and vomiting, seizure, intravenous line failure, etc.
Administrative Event	Delayed surgical start, failure to obtain appropriate consent, failure to complete documentation
Process Event	Allergic reaction, Malignant hyperthermia, cardiac arrest, etc.
Major Event	Death, stroke, reintubation / respiratory failure, etc.
Minor Event	Patient satisfaction (overall), postoperative nausea and/or vomiting, dural puncture headache, etc.

Measure

Display Only

(pulled from selected Outcome)

No

The alphanumeric value assigned to the QCDR or QR measure.

Value

Display Only

(pulled from selected Outcome)

No

The alphanumeric value assigned to the measure's numerators and denominators for AQI reporting.

Value Modifier

Display Only

(pulled from added/edited Outcome)

No

The alphanumeric modifier for the AQI ASA measure associated with the outcome. If a Default Value Modifier was entered for the selected outcome, it will appear in this column; however, up to five characters can be entered in this field to override the default value.

Note

Display Only

(pulled from added/edited Outcome)

No

Any applicable remarks regarding the outcome.

Errors and Warning Section

This section reports problems detected through the Error Check validation process. Use the Display options to select the validations to verify.

In addition to errors and warnings, the date and time the last error check occurred is reported. If an error check has never been performed on a charge batch or case, the text displayed will be Last Check: (pending). Each time an error check is completed, this text is updated and displayed in the following format: Last Check: mm/dd/yyyy, hh:mm:ss AM/PM, for example, Last Check: 07/08/2013, 4:35:14 PM.

Display Filters

Checkboxes

No

This filter determines the type of errors or warnings listed in the Error Check list. Errors must be corrected before a case or charge batch can be submitted and claims can be generated. Warnings may or may not cause rejection of a claim and are not required to be corrected. A checkmark next to the display filter indicates that the filter is selected.

The filter options dynamically affect the contents of the error checklist. When you clear a checkbox, the list hides the applicable errors or warnings. When you click the checkbox again, the list refreshes, showing the hidden errors or warnings.

Type

Read-only

(system-generated)

Yes

The classification of the problem detected in a category during the Error Checking process. Cases in the charge batch are validated for certain conditions reported as errors or warnings.

Type	Description
Errors	Conditions on a case that affect claims generation. Errors must be corrected before cases can be submitted and claims can be created.
Warnings	Conditions on a case that may cause the claim to be rejected by a payer. Warnings do not have to be corrected before cases can be submitted and claims can be created.

Category

Read-only

(system-generated)

Yes

The component that may contain an error or warning when either condition is detected during error check validation, for example, Concurrency or Data. By default, all categories are selected and all errors and warnings are displayed on the Charge Batch Error Check tab. Errors must be corrected before a claim can be created. Warnings do not have to be corrected before a claim can be created.

The categories listed in the error check table are controlled by the Display filters on the Charge Batch Error Check tab. The following categories are available:

Category	Description
Concurrency	Exceptions reported on anesthesia provider time for violations that occur across multiple cases. In most cases, concurrency exceptions are reported as errors unless concurrency validation is excluded on the case. If concurrency is excluded on the case, exceptions are reported as warnings.
CCI	Exceptions reported on code auditing for detecting discrepancies between the diagnosis code and the procedure code. CCI edit warnings are not required to be resolved before a claim can be created, but if not correct, the problems may result in claim rejections by the payer.
ICD-9/ICD-10	Exceptions reported on diagnosis codes for authenticating that the diagnosis is appropriate for a particular age or gender. ICD-9 edit warnings are not required to be resolved before a claim can be created, but if not correct, the problems may result in claim rejections by the payer.
Payer	Exceptions reported on payers or plans for evaluating claim filing rules specific to a payer or plan, for example, provider identification numbers, or date of service of procedure occurs after provider effective date.
Data	Exceptions reported on data for identifying primary data elements (for example, primary diagnosis code) that are missing, are required for all cases, or are required based on specific conditions within a case. Required data must be entered before a claim can be created.

Message

Read-only

(system-generated)

Yes

The description of the error or warning.

Related Cases

Link

No

A direct link to cases related to the case that has a warning or error. To go to a related case, click the direct link. If the related case has a warning or error that is corrected, the Error Check validation process will verify the case and remove it from the Charge Batch Error Check tab.

Button Descriptions

Button	Shortcut Keys	Description	Step-By-Step Guides
Add	[Alt] + [D]	To add an outcome to the case.	Click Add. The Add Outcome window opens. Open the Outcome drop down list and select an outcome. The Measure and Value populates with the values assigned to the outcome when it was created. Enter the alphanumeric Value Modifier for the AQI ASA measure associated with the outcome. Enter any relevant Notes. Click Save (or press [Alt] + S).
Edit	[Alt] + [I]	To edit an existing outcome on the case.	Select the Outcome to be modified. Click Edit. The Edit Outcome window opens. Update the relevant information. Click Save (or press [Alt] + S).
Remove	[Alt] + [R]	To remove an outcome from the table. If the Remove button is unavailable, this means the outcome is either a system value or the outcome is present on a case. The outcome cannot be removed.	Select the Outcome to be deleted. Click Remove. The Delete Case Outcome confirmation message opens. Click Yes.
Add Group	[Alt] + [G]	To add one or multiple outcomes that have been pre-selected to populate when choosing the Add Group option.	Click Add. The Add Outcome Group window opens. Deselect the checkbox in the Default column for any outcome you do not wish to add to the case. Click Save to close the window and add all selected outcomes to the case.
*Error and Warnings Section*
Error Check	[Alt] + [K]	To run the Error Check validation for either a charge batch or a case in a charge batch.	Running Error Check Validation

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Overview

Field Definitions

Field

Type

Required

Description

Button Descriptions

Button

Shortcut Keys

Description

Step-By-Step Guides

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