This is a 66 y.o female patient with history of knee pain x3months, HTN. Pre-test: sodium- 144.

On the day of admission pt.had REPLACEMENT KNEE TOTAL. EBL 100ml, Total IV fluids 2000ml post-op

Noted to have sodium which range from 138 133 131.

Whould you query for hyponatremia?


  • edited May 2016
    We are having this debate in our organization right now. We've been using a company to analyze some of our data to show documentation opportunities. This company was using the values of 135 to 145 so in your scenario, yes - they would expect us to query. Hypo/hypernatremia seems to be a missed opportunity across a significant number of specialties based on the above range.

    That being said, when presenting to our physician leadership for comment our physicians have given some significant pushback and have defined the range to fall between 130 and 150 so applying this range to your scenario, no - no query would be sent. We are asking our physician leadership to "define" this range for our system through CPCs (Clinical Practice Councils) and then we would run our data against the ranges and see if the opportunity still exists or goes away.

    Stacey McIntosh, MBA, MSL, MA, RHIA, CHP, CCS
    HIM Manager

    Health Information Management – System Services
    Memorial Hermann Health System
    909 Frostwood, Suite 2:205:21
    Houston, TX  77024

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