0. Introduction
HI-IQ is our procedure log, complications log and quality assurance database all-in-one. Maintenance of HI-IQ is a very important aspect of our clinical service, and should not be underestimated.
HI-IQ is important to you as a fellow because its data will serve as the procedure record you will use to apply for the CAQ and will take with you to the exam. You will find the data invaluable in expediting patient work-ups. Additionally, it will provide a simple, concise way for you to accumulate and review data for presentation at our Morbidity & Mortality conferences.
HI-IQ also contains data that are needed by the section for use in requests for staffing increases and new equipment, credentialing and turf battles, fellowship accreditation, clinical research, and for JCAHO and Health Department inspections.
HI-IQ data entry must be precise, reproducible, accurate and complete. Make sure you are not creating duplicate entries by manually searching for the patient’s name. Verify hospital number and date of birth to ensure you have found the correct patient (as some patients may have the same name). At University Hospital, old ID numbers (those that contain letters) must be updated. All fields must be filled out, including “patient status”, “date of birth”, “referring MD” and “ASA class”. There must always be a sufficiently detailed diagnosis and indication for the procedure(s) performed in the “notes” field, as well as a description of procedure(s) and findings. Do not abbreviate except with standard, accepted abbreviations, such as PTA. At University Hospital, please note if a case was performed at Riley Hospital or Methodist Hospital. At all hospitals, if a procedure was performed out of the department, note where it was performed (in OR, on floor, in cardiac cath lab, etc.). Patients enrolled in clinical studies should have this noted. If the procedure is a failure, this must be stated in the Outcomes section. ANY and ALL complications, including their outcome, must be recorded and periodically updated in the Complications section. Allergies should be entered in that section, especially contrast allergy.
Please be extremely careful in your data entry of HI-IQ. Most errors are due to carelessness and rushing through data entry. These problems are easily avoidable by reviewing your work before finalizing an entry.
The most confusing aspect of HI-IQ data entry is the proper selection of Services. This Guide was constructed to assist you in this regard. Examples for correct data entry are given under each major heading. This list is dynamic and will expand and change as issues arise.
1. Diagnostic Arteriography
Used for diagnostic arterial procedures, including MR angiography and IVUS.
Usual thoracic aortogram (eg. trauma, peripheral embolism source):
Aortic Injections (Non-selective)
Thoracic Aortic Inject
Aortography, Thoracic
Usual abdominal aortogram (eg. renal artery stenosis without selective angiogram, mesenteric artery stenosis without selective angiogram)
Aortic Injections (Non-selective)
Abdominal Aortic Inject
Aortography, Abdomen
Usual abdominal aortogram and bilateral lower extremity arteriogram (eg. AAA, PVD, flap planning). In general, if a subsequent selection of a lower extremity artery is performed for a repeat unilateral arteriogram because the initial study did not come out well, this should NOT be entered in addition to the non-selective.
Aortic Injections (Non-selective)
Abdominal Aortic Inject
Aortography, Abdomen
Aortic Injections (Non-selective)
Abdominal Aortic Inject
Pelvis/Lower Ext Angio N.S.
Usual selective renal arteriogram (Note: Apply frequency for number of vessels selected; do NOT include non-selective aortic injection):
Visceral Ang Sel
Renal Ang Sel
Usual selective mesenteric arteriogram (Note: Choose all vessels selected; do NOT include non-selective aortic injection):
Visceral Ang Sel
Celiac Ang Sel
Visceral Ang Sel
SMA Ang Sel
Visceral Ang Sel
IMA Ang Sel
Usual arch and carotid arteriogram (Note: Apply frequency 2 unless both carotid arteries NOT selected):
Aortic Injections (Non-selective)
Thoracic Aortic Inject
Cerv-Cerebral Ang N.S.
Neuro Ang (selective)
Carotid Ang Sel
CCA Ang Sel
Usual pulmonary angiogram (Note: Do NOT enter frequency 2, even when both main pulmonary arteries selected):
Pulmonary Ang
Pulm Ang Uni/Bilat Sel
If IVUS performed in conjunction with or instead of conventional arteriography use:
Other Angio Dx
Intravascular ultrasound
Right heart catheterization (usually for pressures and sampling):
Cardiac Ang
Right Heart Cath
All MRA are listed under:
Other Angio Dx
MRA for renal artery stenosis (including transplants) is MRA Renal
MRA for mesenteric ischemia is MRA Visceral
MRA for AAA is MRA Abdomen
MRA for PVD is MRA Aorta and Runoff (only one entry for whole exam; at the VA you need to click the down arrow to view this choice)
2. Arterial Intervention
Used for interventions in the arterial system. Be sure to include all diagnostic arteriographic procedures performed in conjunction with the intervention. Radial arterial line placement is also listed here, although the service is located in Section 1.
Usual arterial angioplasty:
Arterial Interventions
PTA Art General
Choose appropriate vessel
Usual arterial stent:
Arterial Interventions
Stent Art General
Choose appropriate vessel
Usual arterial embolization:
Arterial Interventions
Embolization Art General
Choose appropriate vessel
Usual uterine artery embolization for fibroids (Note: Apply frequency 2 to artery selection unless both uterine arteries NOT selected; do NOT apply frequency 2 to embolization procedure):
Visceral Ang Sel
Hypogastric Ang Sel
Arterial Interventions
Embolization Art General
Embol Visceral A Gnl
Embol Visceral A Other
Uterine Fibroid Embo
Usual aortic stent-graft for AAA:
Arterial Interventions
Arterial Stent Graft
Aortic Stent Graft
Abdominal Aorta Stent Graft
Usual hepatic Lipiodol infusion for HCC identification (Note: Also enter diagnostic angiography services):
Arterial Interventions
Infusion Art (non-lytic)
Inf Visceral A Gnl
Inf Celiac A (or Inf SMA if replaced)
Usual hepatic chemoembolization (Note: Also enter diagnostic angiography services):
Arterial Interventions
Embolization Art General
Embol Visceral A Gnl
Embol Visceral A Other
Hepatic Chembo
Usual radial arterial line (usually placed for PET scanner studies):
Other Angio Dx
Radial artery catheter
3. Venography
Used for venous diagnostic procedures. If MR venography is performed it is usually listed one level under the conventional venogram. See Section 4 for TIPS procedures.
Usual lower extremity venogram (eg. for DVT):
Venography
Veno Peripheral
Veno, Lower Ext
Usual upper extremity venogram, including SVC (eg. for dialysis access planning):
Venography
Veno Peripheral
Veno, Upper Ext
Venography
Veno SVC/IVC
4. Venous Intervention
Used for interventions in the venous system. Be sure to also enter any diagnostic service performed in conjunction with the intervention. Some of these services may be preformed in conjunction with dialysis shunt management services.
Usual temporary central venous catheter placement (eg. triple lumen, temporary dialysis):
Venous Intervention Gnl
Venous Access General
Venous Access Direct Placement
Ven Acc Central Insert
Usual PICC line placement:
Venous Intervention Gnl
Venous Access General
Venous Access Direct Placement
Ven Acc Peripheral Insert (PICC)
Usual tunneled catheter placement (dialysis, pheresis, Hickman, TSBCC/“tunneled PICC”):
Venous Intervention Gnl
Venous Access General
Venous Access Tunneled Placement
Ven Acc Tunnel Ext Port
Superior vena cavagram performed to evaluate for central stenosis or occlusion when venous access placement difficult:
Venography
Veno SVC/IVC
Usual venous port placement (Note: Give brand and catheter size in Findings):
Venous Intervention Gnl
Venous Access General
Venous Access Tunneled Placement
Ven Acc w Port (sub q)
Usual venous access check (eg. for fibrin sheath, catheter leak):
Venous Intervention Gnl
Venous Access General
Venous Access Line Check
Usual over-the-wire venous access change (PICC, temporary, or tunneled) (Note: Do NOT use “Venous Access Stripping” if stripping was performed in conjunction with catheter change):
Venous Intervention Gnl
Venous Access General
Venous Access Line Change
Usual infusion of thrombolytic for venous access with fibrin sheath/thrombus:
Venous Intervention Gnl
Venous Access General
Venous Access Thrombolysis
Usual tunneled catheter or port removal (Note: Do not use if catheter changed over a wire, but do use if an old catheter was removed and a new catheter placed via a new access). Always record catheter data (type, size, and access site), whether cuff was removed, whether tip was sent for culture, and whether cutdown was required (Note: Non-tunneled catheter and PICC removals are not recorded in HI-IQ as a separate entry. They may be added as an addendum in the Notes section in the placement entry.):
Venous Intervention Gnl
Venous Access General
Venous Access Explant
Usual IVC filter placement (Note: Always note type of filter used and access used):
Venography
Veno SVC/IVC
Venous Intervention Gnl
Filter Placement
Filter IVC
Usual venous (including pulmonary artery) foreign body retrieval:
Venous Intervention Gnl
FB Manip Venous
FB Retrieval Venous
Usual adrenal vein sampling (Note: Apply frequency 2 to venogram unless both adrenal veins NOT selected. Do NOT apply frequency 2 to sampling procedure.):
Venography
Veno Central/Visceral Sel
Adrenal Veno
Venous Intervention Gnl
Venous Sampling Select
Venous Sample Non-neuro
Venous Sample Adrenal V
Usual de novo TIPS creation:
Venous Intervention Gnl
TIPS
TIPS Primary
Usual TIPS revision with new stent placement (Note: Do NOT enter TIPS venogram):
Venous Intervention Gnl
TIPS
TIPS Secondary/Redo
TIPS Redo Stent
TIPS venogram without any intervention:
Venography
Veno Portal
TIPS venogram
5. Dialysis Shunt Management
Used for diagnostic and interventional procedures on dialysis fistulas and grafts. Dialysis catheter placement, removal and revision do NOT go in this section. Some of the more complex procedures will require use of services from Section 4.
Usual diagnostic angiogram on a fistula or graft:
Dialysis Shunt Management
If graft/outflow vein angioplasty is also performed:
Dialysis Shunt Management
If central vein angioplasty is also performed:
Venous Intervention Gnl
Venous PTA Gnl
Venous PTA Central
If embolization is also performed, such as for a non-maturing native fistula with competing veins:
Venous Intervention Gnl
Venous Embolization
Usual graft declot with angioplasty make 3 entries:
Dialysis Shunt Management
Dialysis Shunt Management
Dialysis Shunt Management
Dialysis Shunt Thrombectomy
6. Biliary Intervention
Used for hepatobiliary procedures and tube preventive maintenance. Biliary biopsy is part of Section 9.
Usual de novo biliary drainage (internal/external):
PTCholangiography
Biliary Intervention Gnl
Usual preventive maintenance tube check (cholangiogram) and change/upsize (Note: Change frequency if more than 1 tube):
Biliary Intervention Gnl
Bile, Tube Maint Gnl
Bile, Tube Check
Biliary Intervention Gnl
Bile, Tube Maint Gnl
Bile, Tube Exchg
If a cholangioplasty is performed also add:
Biliary Intervention Gnl
Bile Stricture Dil
If a choledochoscopy to remove stones is performed also add:
Biliary Intervention Gnl
Bile, Stone Removal
Transhepatic Stone Rem
Choledochoscopy
Usual percutaneous cholecystostomy:
Cholecystostomy
7. GI Intervention
Used for GI access procedures.
Usual percutaneous gastrostomy:
GI Intervention Gnl
Percutaneous UGI Access
Gastrostomy
Usual placement of jejunostomy through existing gastrostomy (may be done in combination with percutaneous gastrostomy procedure):
GI Intervention Gnl
GI Interven Other
G to J conversion
Placement of single transgastric jejunostomy tube:
GI Intervention Gnl
Percutaneous UGI Access
Gastrojejunostomy
Usual preventive maintenance GI tube change (Note: Do NOT enter GI Tube Check unless necessary, as below):
GI Intervention Gnl
GI Tube Maintenance Gnl
GI Tube Exchange
Usual GI tube check (Note: Use only if there is a definite problem with the tube that requires a tube check for evaluation, not part of preventive maintenance):
GI Intervention Gnl
GI Tube Maintenance Gnl
GI Tube Check
8. GU Intervention
Used for GU access and drainage procedures.
Usual antegrade pyelogram, usually performed in conjunction with nephrostomy tube placement:
GU Intervention Gnl
Antegrade Pyelogram
Usual external nephrostomy tube placement:
GU Intervention Gnl
Nephrostomy
Nephrost External
Usual conversion of external nephrostomy to antegrade J-J ureteral stent with placement of external catheter to retain access (which will be removed the next day):
GU Intervention Gnl
Ureteral Stent (double J)
Ureter Double J Antegrade
Usual percutaneous cystostomy (even if CT guided):
GU Intervention Gnl
Cystostomy
Usual percutaneous access and tract dilatation for nephrolithotomy in OR:
GU Intervention Gnl
Nephrostomy
Nephrost External
GU Intervention Gnl
Renal Stone Manipulation
Neph Tract Dilitation (Stone Dz)
Usual preventive maintenance tube check and change:
GU Intervention Gnl
GU Tube Maintenance Gnl
GU Tube Check
GU Intervention Gnl
GU Tube Maintenance Gnl
GU Exchange
9. Biopsy/Dx Fluid Aspiration
Use when we only remove a sample of tissue or fluid. For all biopsies give information in Findings including: where biopsy taken (“L lobe liver”, “R kidney upper pole”), size of sample (“18 gauge core”), number of samples, number of passes.
Usual percutaneous liver biopsy for diffuse disease:
Biopsy/Dx Fluid Aspiration Gnl
Bx/Asp Abd/Retroperit
Bx/Asp Hepatobiliary
Bx Liver Medical Dz
Usual percutaneous renal biopsy for diffuse disease (transplant or native):
Biopsy/Dx Fluid Aspiration Gnl
Bx/Asp Abd/Retroperit
Bx/Asp Genitourinary
Bx Renal Medical dz
Usual transjugular liver biopsy:
Biopsy/Dx Fluid Aspiration Gnl
Bx/Asp Trans-venous
Bx/Asp Trans-venous, Liver
If hepatic vein wedge pressures also done add:
Venography
Veno Central/Visceral Sel
Hepatic Veno
Hepatic vein wedge pressures
Usual bile duct biopsy (even when performed via biliary drain access):
Biopsy/Dx Fluid Aspiration Gnl
Bx/Asp Abd/Retroperit
Bx/Asp Hepatobiliary
Bx Bile Ducts
10. Drainage
Use any time a catheter is placed, even if removed immediately after drainage.
Usual abdominal abscess drain:
Drainage, General
Drain Abscess/Infection
Drain Intraperitoneal Infect
Usual retroperitoneal abscess drain:
Drainage, General
Drain Abscess/Infection
Drain Retroperitoneal Infect
Usual therapeutic paracentesis:
Drainage, General
Drain NonInfected Collect
Drain Intraperitoneal NonInf
Usual therapeutic thoracentesis:
Drainage, General
Drain NonInfected Collect
Drain Thorax NonInf
Drn Pleura NonInf
Drn Pleural Eff NonInf
Usual abscess drain tube change/upsize/reposition, including preventive maintenance:
Drainage, General
Tube Maint
Tube Exch
Usual abscessogram (when tube not changed, not for preventive maintenance):
Drainage, General
Tube Maint
Tube Check
Usual peritoneal dialysis catheter manipulation:
Drainage, General
Drainage, Other
Peritoneal dialysis catheter manipulation
11. Miscellaneous Intervention
Category nearly never used. We may use in the near future for Direct Tumor Injection. Also includes Lymphangiography, Myelography, Arthrography and a few others.