Consensus Current Procedural Terminology Code Definition of Source Control for Sepsis.

Area of Science:

• Medical Informatics
• Surgical Critical Care
• Health Services Research

Background:

• Guidelines for sepsis source control lack high-quality evidence and are ungraded.
• There is a need for internally valid administrative data methods to identify source control procedures for outcome evaluation.

Purpose of the Study:

• To create and validate Current Procedural Terminology (CPT) codes for identifying sepsis source control procedures.
• To establish a framework for evaluating the surgical care of sepsis patients using administrative data.

Main Methods:

• Modified Delphi methodology with two independent reviewers to identify relevant CPT codes.
• Manual review of 400 patient records meeting Sepsis-3 criteria to clinically adjudicate source control procedures (gold standard).
• Comparison of consensus codes against the gold standard to assess performance metrics like sensitivity and specificity.

Main Results:

• 609 consensus CPT codes were identified as representing source control procedures.
• The consensus codes demonstrated 61.5% sensitivity and 98.6% specificity in identifying source control procedures.
• An identified consensus code had an 83.0% posttest probability of a source control procedure being performed.

Conclusions:

• A validated set of CPT codes for sepsis source control procedures was developed using the modified Delphi methodology.
• These consensus codes provide a framework for evaluating the surgical care of patients with sepsis.
• The validated codes can facilitate outcome evaluation using administrative data.