1. (a) ICD-CM codes as designated by the federal Centers for Disease Control and Prevention's National Healthcare Safety Network (NHSN) or its successor shall constitute the definition of events listed in this rule. Facilities shall adapt to changes in ICD-CM specifications as directed by NHSN and the department.
2. (b) All general hospitals shall report the number of device days and laboratory-confirmed central line-associated primary bloodstream infections in special care settings including the causative pathogen.

3. (c) General hospitals, other than pediatric and adolescent hospitals, and ambulatory surgical centers shall report the HAI data related to the following surgical procedures. The surgical procedure is defined by the NHSN operative procedure and the associated ICD-CMcodes linked to that operative procedure in NHSN.

   1. (1) Colon surgeries (Colon surgery).
   2. (2) Hip arthroplasties (Hip prosthesis).
   3. (3) Knee arthroplasties (Knee prosthesis).
   4. (4) Abdominal hysterectomies (Abdominal hysterectomy).
   5. (5) Vaginal hysterectomies (Vaginal hysterectomy).
   6. (6) Coronary artery bypass grafts (Coronary artery bypass graft with both chest and donor site incisions and Coronary artery bypass graft with chest incision only).
   7. (7) Vascular procedures (Abdominal aortic aneurysm repair, Carotid endarterectomy, and Peripheral vascular bypass surgery).

4. (d) Pediatric and adolescent hospitals shall report the HAI data relating to the following surgical procedures. The surgical procedure is defined by the NHSN operative procedure and the associated ICD-CM codes linked to that operative procedure.

   1. (1) Spinal surgery with instrumentation (Spinal fusion, Laminectomy and Refusion of spine).
   2. (2) Cardiac procedures, excluding thoracic cardiac procedures (Cardiac surgery and Heart transplant).
   3. (3) Ventriculoperitoneal shunt procedures (Ventricular shunt operations), including revision and removal of shunt.
5. (e) Facilities shall also report denominator data for the events identified in this rule for calculation of risk adjusted infection rates as required in Texas Health and Safety Code, §98.106(b). NHSN protocols shall be used for the determination of denominator data.

Source Note:The provisions of this §200.4 adopted to be effective May 4, 2011, 36 TexReg 2729; amended to be effective August 7, 2012, 37 TexReg 5793.