Global: ^SRF

1)= S ^SRF("B",$E(X,1,30),DA)=""

2)= K ^SRF("B",$E(X,1,30),DA)

1)= Q

2)= D ^SROKRET

The ARET cross reference on the PATIENT field removes returns to surgery that are defined for other cases when a case is deleted.  In addition, the ARET cross reference includes logic to remove AL and AUD nodes (on case

deletion) that may exist because of the reverse set and kill logic on the AL and AUD cross references.

follow your hospital's definition of inpatient and outpatient status.

1)= D APCE^SROPCEX

2)= Q

This MUMPS cross reference updates PCE.

This is the visit associated with this case.

1)= S ^SRF("AV",$E(X,1,30),DA)=""

2)= K ^SRF("AV",$E(X,1,30),DA)

This is a regular cross reference to be used for sorting.

1)= D ADD^AUPNVSIT

2)= D SUB^AUPNVSIT

This MUMPS cross reference maintains the dependency count for this visit in the VISIT file.

null, it will not permit a choice if the site parameter to enter classification information is turned on.

This field will be used to indicate if this surgery or non-OR procedure is treating a VA patient for a service connected problem.  This information may be passed to the VISIT file (#9000010) for use by PCE.

1)= D APCE^SROPCEX

2)= Q

This MUMPS cross reference updates PCE.

by PCE.

1)= D APCE^SROPCEX

2)= Q

This MUMPS cross reference updates PCE.

for use by PCE.

1)= D APCE^SROPCEX

2)= Q

This MUMPS cross reference updates PCE.

This field will be used to indicate if this surgery or non-OR procedure is treating a VA patient for a problem related to service in SW Asia.  This information may be passed to the VISIT file (#9000010) for use by PCE.

1)= D APCE^SROPCEX

2)= Q

This MUMPS cross reference updates PCE.

This is the name of the operating room where the principal operation is performed for this patient.  It can be selected by entering the name  or abbreviation of the operating room.

1)= I $P(^SRF(DA,0),"^",9)'="" S ^SRF("AOR",X,$E($P(^SRF(DA,0),"^",9),1,7),DA)=""

2)= K ^SRF("AOR",X,$E($P(^SRF(DA,0),"^",9),1,7),DA)

The AOR cross reference on the OPERATING ROOM field is used in various reports when sorting by operating room.

1)= D AM3^SROXR2

2)= D KILLAM3^SROXR2

The AM3 cross reference on the OPERATING ROOM field updates the AMM cross reference when the OPERATING ROOM is edited if the case has been scheduled.

1)= D APCE^SROPCEX

2)= Q

This MUMPS cross reference updates PCE.

This is the clinic associated with this surgical case or non-OR procedure.  The entry made in this field will be used as the location of the encounter for PCE.

1)= D APCE^SROPCEX

2)= Q

This MUMPS cross reference updates PCE.

by PCE.

1)= D APCE^SROPCEX

2)= Q

This MUMPS cross reference updates PCE.

use by PCE.

1)= D APCE^SROPCEX

2)= Q

This MUMPS cross reference updates PCE.

This field will be used to indicate if this surgery or non-OR procedure is treating a VA patient for a problem that is related to Combat.  This information may be passed to the VISIT file (#9000010) for use by PCE.

1)= D APCE^SROPCEX

2)= Q

This MUMPS cross reference updates PCE.

This field will be used to indicate if this surgery or non-OR procedure is treating a VA patient for a problem that is related to PROJ 112/SHAD.  This information may be passed to the VISIT file (#9000010) for use by PCE.

1)= D APCE^SROPCEX

2)= Q

This MUMPS cross reference updates PCE.

anesthesia plus all inguinal herniorrhaphies, carotid

endarterectomies, parathyroidectomies, thyroidectomies, breast

lumpectomies, or endovascular AAA repairs regardless of

anesthesia administered.

Minor - All operations not designated as Major.

NSQIP Definition of Emergency Case (2004): An emergency case is usually performed as soon as possible and no later than 12 hours after the patient has been admitted to the hospital or after the onset of related

preoperative symptomatology. Answer EMERGENCY if the surgeon and anesthesiologist report the case as emergent

1)= D NOW^SROAUTLC

2)= D KNOW^SROAUTLC

This cross reference stuffs the current date/time into the Date/Time of Cardiac Surgical Priority field (414.1).

more than one case.

be entered prior to completion of this case. (If you enter '?' in the surgical package, it will display the entire local surgical specialty list and a copy of the national list can be found in the Operations Manual.)

1)= I $P(^SRF(DA,0),"^",9)'="" S ^SRF("ASP",X,$E($P(^SRF(DA,0),"^",9),1,7),DA)=DA

2)= K ^SRF("ASP",X,$E($P(^SRF(DA,0),"^",9),1,7),DA)

The ASP cross reference on the SURGERY SPECIALTY field is used by various reports to sort by the surgical specialty and within surgical specialty by date of operation.

1)= D APCE^SROPCEX

2)= Q

This MUMPS cross reference updates PCE.

This is the date that the case was performed.  The date of operation must be entered for all cases.

TRIGGERED by the TIME PAT IN OR field of the SURGERY File

TRIGGERED by the DATE OF PROCEDURE field of the SURGERY File

1)= S ^SRF("AC",X,DA)=$P(^SRF(DA,0),"^")

2)= K ^SRF("AC",X,DA)

The AC cross reference on the DATE OF OPERATION field is used to sort entries by date of operation for reports.

1)= D ADT^SROXR2

2)= D KADT^SROXR2

The ADT cross reference on the DATE OF OPERATION field uses the 'inverse' date/time format to sort and to display cases by inverse chronological order.

1)= D SP^SROXR1

2)= D KSP^SROXR1

The ASP1 cross reference on the DATE OF OPERATION field updates the ASP and the AOR cross references when the date of operation is changed.

1)= D AR^SROXR1

2)= D KAR^SROXR1

The AR cross reference on the DATE OF OPERATION field is used to sort and display requested cases.  This cross reference is created when a case is requested or when the request date is changed.  Upon scheduling the

request, the AR cross reference for the case is deleted.

Short Descr:  Update TIU when Date of Operation is changed.

Description:  This cross-reference is responsible for updating the REFERENCE DATE field (#1301) in the TIU DOCUMENT file (#8925) for all Reports when the DATE OF OPERATION field (#9) in the SURGERY file (#130) is edited.

Set Logic:  D AES8^SROESX0 Q

Set Cond:  S X=((X1(1)'=X2(1))&(X2(1)'=""))

Kill Logic:  Q

X(1):  DATE OF OPERATION  (130,.09)  (forwards)

Short Descr:  PFSS field monitor flag.

Description:  This cross-reference will be checked before sending a notification to the PFSS after editing the Date Of Operation field.

Set Logic:  I ($P(X1(1),".")'=$P(X2(1),"."))&(X2(1)'="") S ^TMP("SRPFSS",$J)="" Q

Set Cond:  Q

Kill Logic:  I ($P(X1(1),".")'=$P(X2(1),"."))&(X1(1)'="") S ^TMP("SRPFSS",$J)="" Q

Kill Cond:  Q

X(1):  DATE OF OPERATION  (130,.09)  (forwards)

This is the person responsible for removing the patient's hair in preparation for the operative procedure (if necessary).

This field may be restricted by locally determined keys so that only people with the appropriate keys can be entered.

1)= D STAFF^SROXR1

2)= D KSTAFF^SROXR1

The ASR cross reference on the SURGEON field is used to update the STAFF/RESIDENT field when a surgeon is entered.

1)= D APCE^SROPCEX

2)= Q

This MUMPS cross reference updates PCE.

1)= D ATT^SROXR1

2)= D KATT^SROXR1

This cross reference updates the ATTEND SURG field with the SURGEON if the SURGERY RESIDENTS (Y/N) site parameter is NO.

Short Descr:  Update TIU when surgeon is changed.

Description:  This cross reference is responsible for updating the AUTHOR/DICTATOR field (#1202) and the EXPECTED SIGNER field (#1204) in the TIU DOCUMENT file (#8925) for the Operation Report when the surgeon is edited.

Set Logic:  D SET^SROESX0

Set Cond:  S X=X1(1)'=X2(1)

Kill Logic:  Q

Kill Cond:  S X=0

X(1):  SURGEON  (130,.14)  (forwards)

This is the name of the person assisting the surgeon during the operative procedure.  The information entered here appears on the Operation Report and Nurse Intraoperative Report.

1)= D APCE^SROPCEX

2)= Q

This MUMPS cross reference updates PCE.

Short Descr:  Update TIU when attending surgeon is changed.

Description:  This cross reference is responsible for updating the EXPECTED COSIGNER field (#1208) and the ATTENDING PHYSICIAN field (#1209) in the TIU DOCUMENT file (#8925) for the Operation Report when the attending surgeon is edited.

Set Logic:  D SET1^SROESX0

Set Cond:  S X=((X1(1)'=X2(1))&(X2(1)'=""))

Kill Logic:  D SET1^SROESX0

Kill Cond:  S X=X2(1)=""

X(1):  ATTEND SURG  (130,.164)  (forwards)

This is the code corresponding to the highest level of supervision provided by the attending staff surgeon for this case.  This information appears in the Operation Report, Nurse Intraoperative Report, and Attending

Surgeon Report.

0   The staff practitioner performs the case but may be assisted by

a resident.

1   The supervising practitioner is physically present in the

operative or procedural suite and directly involved in the

procedure. The resident performs major portions of the procedure.

2   The supervising practitioner is physically present in the

operative or procedural suite and immediately available for

consultation. The supervising practitioner may observe and

provide direction.  The resident performs the procedure

3   The supervising practitioner is not physically present in the

operative or procedural suite, but is in the facility or on the

VA campus. The supervising practitioner is immediately available

for resident supervision or consultation as needed.  Local policy,

as approved by the VISN Academic Affiliations Officer, should

define the standard for "availability" of the supervising

practitioner.  NOTE: The service chief and chief of staff

are responsible for periodically reviewing cases done under

Level 3 supervision.

WRITE AUTHORITY:  ^

UNEDITABLE

This is the code corresponding to the highest level of resident supervision provided by the attending staff surgeon for this case.

Intraoperative Report.

Intraoperative Report.

This is the date and time that the nurse was present in the operating room.  Times entered without a date will be converted to the date of operation at that time.

NSQIP Definition (2004): Patient in Room (PIR): Time when patient enters the OR/PR.

1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^SRF(D0,0)):^(0),1:"") S X=$P(Y(1),U,9),X=X S DIU=X K Y S X=DIV S X=DIV S DIH=$S($D(^SRF(DIV(0),0)):^(0),1:""),DIV=X S $P(^(0),U,9)=DIV,DIH=130,DIG=.09 D ^DICR

2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^SRF(D0,0)):^(0),1:"") S X=$P(Y(1),U,9),X=X S DIU=X K Y X ^DD(130,.205,1,1,2.1) X ^DD(130,.205,1,1,2.4)

2.1)= S X=DIV S X=X,Y(1)=X S X=1,Y(2)=X S X=7,X=$E(Y(1),Y(2),X)

2.4)= S DIH=$S($D(^SRF(DIV(0),0)):^(0),1:""),DIV=X S $P(^(0),U,9)=DIV,DIH=130,DIG=.09 D ^DICR

CREATE VALUE)= TIME PAT IN OR

DELETE VALUE)= $E(OLD TIME PAT IN OR,1,7)

FIELD)= DATE OF OPERATION

This trigger on the TIME PAT IN OR field updates the DATE OF OPERATION field with the date/time the patient went into the operating room.

1)= D APCE^SROPCEX

2)= Q

This MUMPS cross reference updates PCE.

1)= D VALIDAT^SROCVER

2)= Q

This MUMPS cross-reference on the TIME PAT IN OR field is used to invoke the CPT and ICD-9 codes revalidation checks in routine ^SROCVER.

1)= I $L($T(OR1^ORMEVNT1)) D OR1^ORMEVNT1(DA,X)

2)= I $L($T(OR2^ORMEVNT1)) D OR2^ORMEVNT1(DA)

This MUMPS cross reference allows the CPRS to automatic discontinue or release orders when the patient enters the OR.

NSQIP Definition (2004): Anesthesia Start (AS): Time when a member of the anesthesia team begins preparing the patient for an anesthetic.

1)= Q:'$D(SRTN)!('$D(SRSITE("IV")))!('$D(DT))  I SRSITE("IV") D IV^SROXR1

2)= Q

The AF MUMPS cross reference on this field is responsible for canceling current IV orders for a patient undergoing a surgical or non-OR procedure if the site parameter is set to allow cancellation of IV orders.

This cross reference compares the time entered in the ANES CARE START TIME field with the current time. If the difference is more than 24 hours, order cancellation is not allowed. If the difference is more than 1 hour, but

not more than 24 hours, the user is warned that a considerable amount of time has passed since the start of the operation or procedure. Finally, if order cancellation is allowed, the user is prompted to cancel current IV

orders or not. If the user chooses to cancel IV orders, the Surgery software calls DCOR^PSIVACT.

This is the date and time for which anesthesia care is provided.

is not complete.

This is the total anesthesia care billable time in minutes. It is calculated from all time intervals entered in the multiple anesthesia start and end time fields..

NSQIP Definition (2004): Procedure/Surgery Start Time (PST): Time the procedure is begun (e.g., incision for a surgical procedure).

dressings and drains are secured; and the physician/surgeons have completed all procedure-related activities on the patient. Should the patient expire in the operating room, indicate the time the patient was pronounced

dead.

management studies.

NSQIP Definition (2004): Patient Out of Room (POR): Time at which patient leaves OR/PR.

CICSP Definition (2004): Indicate the time the patient was transported out of the operating room. If the patient dies prior to leaving the OR, then indicate the time of death for this data element.

1)= I $D(^SRF(DA,14)),'$D(^(15)) S %X="^SRF(DA,14,",%Y="^SRF(DA,15," D %XY^%RCR S ^(0)="^130.18A"_U_$P(^SRF(DA,15,0),U,3,4) K %X,%Y

2)= Q

The AH cross reference on the TIME PAT OUT OR field moves the OTHER PREOP DIAGNOSIS information into the OTHER POSTOP DIAGS subfile when the TIME PAT OUT OR is entered.

1)= D AM1^SROXR2

2)= Q

The AM1 cross reference on the TIME PAT OUT OR field is responsible for removing the AMM cross reference for the case and for updating the scheduling display graph.  In addition, if the case is a reqested case, the AR

cross reference is removed if it still exists.

1)= D APCE^SROPCEX

2)= Q

This MUMPS cross reference updates PCE.

1)= D AQ^SROXR4

2)= D KAQ^SROXR4

This MUMPS cross reference is used by the transmission process to the national database.

Short Descr:  Create/delete stub entries in TIU for nurse/operation reports.

Description:  This cross reference is responsible for creating stub entries in TIU for the nurse intraoperative report and the operation report when the TIME PAT OUT OR field (#.232) is entered.  It is also responsible for deleting the

stub entries in TIU for these same reports, if unsigned, when the TIME PAT OUT OR field (#.232) is deleted.  No action occurs if the value in the TIME PATOUT OR field (#.232) is modified.

Set Logic:  D AES^SROESX

Set Cond:  S X=X1(1)=""

Kill Logic:  D KAES^SROESX

Kill Cond:  S X=X2(1)=""

X(1):  TIME PAT OUT OR  (130,.232)  (forwards)

converted to the date of the operation at that time.

NSQIP Definition (2004): Anesthesia Finish (AF): Time at which anesthesiologist turns over care of the patient to a post anesthesia care team (either PACU or ICU).

Short Descr:  Create/delete stub entries in TIU for anesthesia report.

Description:  This cross reference is responsible for creating a stub entry in TIU for the anesthesia report when the ANES CARE END TIME field (#.24) is entered.  It is also responsible for deleting the stub entry in TIU for this

report, if unsigned, when the ANES CARE END TIME field (#.24) is deleted.  No action occurs if the value in the ANES CARE END TIME field (#.24) is modified.

Set Logic:  D AESA^SROESXA

Set Cond:  S X=X1(1)=""

Kill Logic:  D KAESA^SROESXA

Kill Cond:  S X=X2(1)=""

X(1):  ANES CARE END TIME  (130,.24)  (forwards)

This is information related to the replacement fluid given intravascularly during the operative procedure.

These are comments on this case required for documentation on the Nurse Intraoperative Report.

1)= D ANES^SROXR1

2)= D KANES^SROXR1

The ANES cross reference on the PRINC ANESTHETIST field updates the ANESTHETIST CATEGORY field when a principal anesthetist is entered.

Short Descr:  Update TIU when principal anesthetist is changed.

Description:  This cross reference is responsible for updating the AUTHOR/DICTATOR field (#1202) and the EXPECTED SIGNER field (#1204) in the TIU DOCUMENT file (#8925) for the Anesthesia Report when the principal anesthetist is edited.

Set Logic:  D SET2^SROESX0

Set Cond:  S X=((X1(1)'=X2(1))&(X2(1)'=""))

Kill Logic:  D SET2^SROESX0

Kill Cond:  S X=X2(1)=""

X(1):  PRINC ANESTHETIST  (130,.31)  (forwards)

status, or CRNA.

Short Descr:  UPdate TIU when anesthesiologist supervisor is changed.

Description:  This cross reference is responsible for updating the EXPECTED COSIGNER field (#1208) and the ATTENDING PHYSICIAN field (#1209) in the TIU DOCUMENT file (#8925) for the Anesthesia Report when the anesthesiologist supervisor

is edited.

Set Logic:  D SET3^SROESX0

Set Cond:  S X=((X1(1)'=X2(1))&(X2(1)'=""))

Kill Logic:  D SET3^SROESX0

Kill Cond:  S X=X2(1)=""

X(1):  ANESTHESIOLOGIST SUPVR  (130,.34)  (forwards)

Answer yes only if the anesthesiologist personally performed the entire anesthesia procedure.

Did the anesthesiologist personally perform the anesthesia care? This field only accepts and displays a "Y" for yes or "N" for no.  The set of codes  stores/translates 1 = YES and 0 = No.

for accurate coding of the primary anesthesia procedure.  Enter a zero if the anesthesiologist personally performed the care.  Enter 1 if the principal anesthetist was not an anesthesiologist and was medically directed by

an anesthesiologist.

Total number of concurrent cases the anesthesiologist supervised during this care? This field can contain only one digit.

This field is for information only and is not required. It will assist in correcting potential errors if a start or end time is edited since other cases could be affected by the edit.

This field lists the concurrent anesthesia cases to this case by the SURGERY case number.

If the principal anesthetist was other than an anesthesiologist, answer yes if an anesthesiologist supervised the care.  Answering no indicates that the anesthetist was unsupervised.

Was the CRNA medically directed by an anesthesiologist during this care? This field only accepts and displays a "Y" for yes or "N" for no.  The set of codes  stores/translates 1 = YES and 0 = NO.

If the anesthetist was a resident, answer yes if the teaching physician was present during all key portions of the procedure and immediately available during the entire procedure.

stores/translates 1 = YES and 0 = NO.

This is information about medication for this case.

1)= I $S('$D(^SRF(DA,.7)):1,$P(^(.7),U,9)="":1,1:0) S $P(^SRF(DA,.7),U,9)=X

2)= Q

The AI cross reference on the REQ POSTOP CARE field stuffs the requested post-operative care entry into the PACU DISPOSITION field.

This field is marked for deletion.

setting, cut setting, blend-BI:Setting and Bipolar BP:Setting.  Examples:

Electrocautery Unit: #7 HP206  COAG:50  CUT:50  BI:1

Electrocautery Unit: DAISY:18%  or  DAISY BP:18%

Electrocautery Unit: VL#2 EXP 3/20/91 COAG:30 CUT:20 BI:2  #2 BP:20

(VL-VALLEYLAB)

This field is not being used and is marked for deletion.

This field has been marked for deletion.

This field has been marked for deletion in the next version of the Surgery package.

This field has been marked for deletion in the next version of the Surgery package.

>> Class 1 - Clean (C): Respiratory, alimentary, genital, or uninfected urinary tracts are not entered. Uninfected surgical wounds. No inflammation is encountered. Closed primarily and, if necessary, drained with closed

drainage. Surgical incisional wounds that occur with nonpenetrating (eg blunt) trauma should be included in this category if they meet the criteria.

[No hollow organ (e.g. bladder, stomach, vagina, lung, etc.) is entered; no breaks in aseptic technique.]

Examples:

- Exploratory laparotomy

- Mastectomy or breast reduction

- Neck dissection

- Nonpenetrating blunt trauma

- Thyroidectomy

- Total hip replacement

- Vascular operations (e.g. AAA, AV fistula, CEA, aortoiliac bypass)

- Hernia repair

- CABG, AVR

- Craniotomy, majority neurosurgery

- Pleura biopsy

- Sternotomy

- Abdominoplasty

- Bone anchored hearing aids (BAHA)

- Penile prosthesis placement

- Dupuytren's release, finger

- Liposuction

- Carpal tunnel release

- Hydrocele repair

>> Class 2 - Clean/Contaminated (CC): Respiratory, alimentary, genital, or urinary tracts are entered under controlled conditions and without unusual contamination. Specifically, procedures involving the biliary tract,

appendix, vagina, and oropharynx are included in this category, provided no evidence of infection or major breaks in technique are encountered.

(Hollow organ entered but controlled; no inflammation; primary wound closure; minor break in aseptic technique; mechanical drain used.)

Examples:

- Bronchoscopy

- Routine appendectomy

- Cholecystectomy (e.g., any approach)

- Laryngectomy

- Small bowel resection

- Oropharynx entered

- GYN procedures

- Vagina entered

- Whipple pancreaticoduodenectomy

- Pulmonary resection

- Transurethral resection of prostate

- Head & Neck cancer operations (e.g., oropharynx)

- Sigmoid colectomy

- Minor break in technique

- Gastrointestinal or respiratory tract entered without significant

spillage

- Genitourinary tract entered in absence of infected urine

>> Class 3 - Contaminated (D): Open fresh, accidental (e.g. traumatic) wounds. Procedures that have major breaks in sterile technique (eg, open cardiac massage) or gross spillage from the gastrointestinal tract and

incisions in which acute, nonpurulent inflammation is encountered are included in this category.

Examples:

- Appendectomy for gangrenous appendicitis

- Bile spillage during cholecystectomy

- Diverticulitis

- Laparotomy for penetrating injury with intestinal spillage

- Entrance of genitourinary or biliary tracts in presence of infected

urine or bile

- Necrotic tissue without evidence of purulent drainage (e.g. dry

gangrene)

>> Class 4 - Dirty/Infected (I): Old traumatic wounds that have retained devitalized tissue and those that involve existing clinical infection or perforated viscera. This definition suggests that the organisms causing

postoperative infection were present in the surgical field before the procedure.

(Untreated, uncontrolled spillage from an internal organ; pus in operative wound; open suppurative wound; severe inflammation.)

Examples:

- Excision and drainage of abscess

- Myringotomy for otitismedia

- Perforated bowel

- Peritonitis (abdominal exploration for acute bacterial peritonitis)

- Acute bacterial inflammation, without pus

- Transection of 'clean' tissue for the purpose of surgical access to

a collection of pus

- Traumatic wound with foreign bodies, fecal contamination, or delayed

treatment, or all of these; or from dirty source

requested.

UNEDITABLE

likely there will be a 2nd assessment of the ASA class prior to anesthesia induction. If this is available, report this most recent assessment. The definitions are:

ASA 1 - A normal healthy patient

ASA 2 - A patient with mild systemic disease

ASA 3 - A patient with severe systemic disease

ASA 4 - A patient with severe systemic disease that is a constant

threat to life

ASA 5 - A moribund patient who is not expected to survive without

the operation

ASA 6 - A declared brain-dead patient whose organs are being

removed for donor purposes

ASA 6 cases should be excluded.

Classification numbers followed by an 'E' indicate an emergency.

NSQIP Definition (2004): Discharge from Post-Anesthesia Care Unit (DPACU): Time patient is transported out of PACU.

This is the postoperative anesthesia note for this patient.

9.2 = S Y(130,1.21,1)=$S($D(^SRF(D0,.2)):^(.2),1:"") S X=$P(Y(130,1.21,1),U,3),Y(130,1.21,2)=X S X=$P(Y(130,1.21,1),U,2)

9.2 = S Y(130,1.22,1)=$S($D(^SRF(D0,.2)):^(.2),1:"") S X=$P(Y(130,1.22,1),U,11),Y(130,1.22,2)=X S X=$P(Y(130,1.22,1),U,1)

9.2 = S Y(130,1.23,1)=$S($D(^SRF(D0,.2)):^(.2),1:"") S X=$P(Y(130,1.23,1),U,4),Y(130,1.23,2)=X S X=$P(Y(130,1.23,1),U,1)

9.2 = S Y(130,1.24,1)=$S($D(^SRF(D0,.2)):^(.2),1:"") S X=$P(Y(130,1.24,1),U,12),Y(130,1.24,2)=X S X=$P(Y(130,1.24,1),U,10)

9.2 = S Y(130,1.25,1)=$S($D(^SRF(D0,.2)):^(.2),1:"") S X=$P(Y(130,1.25,1),U,14),Y(130,1.25,2)=X S X=$P(Y(130,1.25,1),U,13)

9.2 = S Y(130,1.26,1)=$S($D(^SRF(D0,1.1)):^(1.1),1:"") S X=$P(Y(130,1.26,1),U,8),Y(130,1.26,2)=X S X=$P(Y(130,1.26,1),U,7)

1)= D AM2^SROXR2

2)= D KILLAM2^SROXR2

The AM2 cross reference on the SCHEDULED START TIME field resets the AMM cross reference for the case when the scheduled start time is edited.

1)= D AMM^SROXR2

2)= D KILLAMM^SROXR2

The AMM cross reference on the SCHEDULED END TIME field sets the AMM cross reference for the case if the operating room and the scheduled start time are defined.

9.2 = S Y(130,12,1)=$S($D(^SRF(D0,.2)):^(.2),1:"") S X=$P(Y(130,12,1),U,1),Y(130,12,2)=X S X=$P(Y(130,12,1),U,10)

9.2 = S Y(130,13,1)=$S($D(^SRF(D0,.2)):^(.2),1:"") S X=$P(Y(130,13,1),U,2),Y(130,13,2)=X S X=$P(Y(130,13,1),U,1)

9.2 = S Y(130,14,1)=$S($D(^SRF(D0,.2)):^(.2),1:"") S X=$P(Y(130,14,1),U,2),Y(130,14,2)=X S X=$P(Y(130,14,1),U,10)

1)= D CAN^SROXR4

2)= D KCAN^SROXR4

The ACAN cross reference on the CANCEL REASON field functions to stuff for the CANCEL REASON the default CANCELLATION AVOIDABLE (Y or N) as defined in the SURGERY CANCELLATION REASON file.  It also stuffs the CANCELLED BY

field with the user if not already defined.

This is start of the patient's "wait" for Surgery. Typically, this is the date that the patient was notified that Surgery is needed.

1)= K ^SRF("AL",DA)

2)= S ^SRF("AL",DA)=""

The AL cross reference on the LOCK CASE field uses reverse set and kill logic to flag cases that have been locked, then unlocked.  The cross reference for the case is set when the field is deleted and is killed when the

field is set.

The principal procedure must be 3 to 135 characters in length. The procedure name must not contain a semicolon (;), an at-sign (@), an up- arrow (^) or control characters. If the procedure name is longer than 30

characters, it must contain at least one space in every 31 characters of length. If a comma is being used to separate information, a space should follow the comma.

NSQIP Definition (2004): The most complex of all the procedures by the primary operating team during this trip to the operating room. Your answer must be at least 3 characters in length. Do not enter an additional

procedure if it is covered by a single CPT code. (Note that a single CPT code can cover more than one procedure, e.g., cholecystectomy and common bile duct exploration have a single CPT code). Additional procedures

requiring separate CPT codes and/or concurrent procedures will be entered separately below. An exploratory laparotomy should be entered as the principal operative procedure only when no other procedure eligible for

assessment has been performed in that particular surgical case.

the format "XXXXX-YY" where "XXXXX" is the five character CPT code and "YY" is the two character CPT modifier.

1)= D SPRIN^SROMOD

2)= D KPRIN^SROMOD

This MUMPS cross reference provides for updating CPT modifiers for the principal procedure code.  CPT modifiers for the PRINCIPAL PROCEDURE CODE field (#27) are stored in the PRIN. PROCEDURE CPT MODIFIER field (#.01) of

the PRIN. PROCEDURE CPT MODIFIER multiple field (#28) in SURGERY file (#130).

After selecting a CPT code, this cross reference prompts the user for a CPT modifier.  If a CPT modifier was entered concatenated with a hyphen to the CPT code, this CPT modifier is displayed as a default modifier. Upon

entering a CPT modifier, the user is prompted for another CPT modifier until the user makes a null entry. CPT modifier input is controlled by the input transform on the PRIN. PROCEDURE CPT MODIFIER field (#28). At the CPT

modifier prompt, the user may to enter a question mark (?) to see a list of CPT modifiers already entered and a list of acceptable CPT modifiers to choose from.  If the user selects a modifier already entered, the user may

change or delete the modifier.  If a user enters a new CPT code, replacing a previously entered CPT code, KILL logic on the ACPT cross reference deletes any previously entered CPT modifiers for the old CPT code before the

SET logic prompts the user to enter CPT modifiers for the new CPT code.

This Surgery sub-file is used to store the Procedure/Diagnosis association data.

This field has been marked for deletion.

This is the preoperative diagnosis for which the surgical procedure is being performed.

1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^SRF(D0,34)):^(34),1:"") S X=$P(Y(1),U,1),X=X S DIU=X K Y S X=DIV S X=DIV X ^DD(130,32,1,1,1.4)

1.4)= S DIH=$S($D(^SRF(DIV(0),34)):^(34),1:""),DIV=X S %=$P(DIH,U,2,999),DIU=$P(DIH,U,1),^(34)=DIV_$S(%]"":U_%,1:""),DIH=130,DIG=34 D ^DICR:$O(^DD(DIH,DIG,1,0))>0

2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^SRF(D0,34)):^(34),1:"") S X=$P(Y(1),U,1),X=X S DIU=X K Y X ^DD(130,32,1,1,2.1) X ^DD(130,32,1,1,2.4)

2.1)= S X=DIV S Y(1)=$S($D(^SRF(D0,33)):^(33),1:"") S X=$P(Y(1),U,1)

2.4)= S DIH=$S($D(^SRF(DIV(0),34)):^(34),1:""),DIV=X S %=$P(DIH,U,2,999),DIU=$P(DIH,U,1),^(34)=DIV_$S(%]"":U_%,1:""),DIH=130,DIG=34 D ^DICR:$O(^DD(DIH,DIG,1,0))>0

CREATE VALUE)= PRINCIPAL PRE

DELETE VALUE)= PRINCIPAL PRE

FIELD)= PRINCIPAL PO

This trigger on the PRINCIPAL PRE-OP DIAGNOSIS field stuffs the PRINCIPAL POST-OP DIAGNOSIS field with what is entered as the PRINCIPAL PRE-OP DIAGNOSIS.

1)= Q

2)= D DELASOC^SROADX2

This cross reference removes associations from diagnosis being deleted.

This is the principal Pre-OP ICD diagnosis code.  It should be entered for all cases.

1)= S $P(^SRF(DA,34),"^",2)=X

2)= Q

This cross reference stuffs the current value of the PRIN PRE-OP ICD DIAGNOSIS CODE field (#32.5) into the PRIN DIAGNOSIS CODE field (#66).