View source for Query check CCI ICD10 Dialysis no Dx

{{Data Integrity Check
|DIC_summary=If there is a [[TISS28]] entry for Hemodialysis there should be a corresponding Dx.
|DIC_related_concepts=Intermittent hemodialysis (TISS Item); Peritoneal dialysis (TISS Item); CRRT (TISS Item); {{#ask: [[Concept:Acute renal failure]]|default=none found|format=plainlist|link=none|limit=100|sep=;}}
|DIC_firmness=hard check
|DIC_timing=complete
|DIC_coding=query ''NDC_Dxs_vs_TISS_Dialysis''
|DIC_implementation_date=2019/01/06
|DIC_status=needs review
|DIC_LProblem=No
|DIC_app=Centralized data front end.accdb
}}


{{DiscussTask | We are getting a lot of positives where a requiring dx does not have a TISS. Is our list of requiring dxs reasonable? }}

{{#ask: [[Concept:Acute renal failure]]|default=none found|format=plainlist|link=none|limit=100|sep=;}}


If there is a [[TISS28]] entry for Hemodialysis there should be a corresponding Dx.

=== Dialysis TISS Items ===
*[[Intermittent hemodialysis (TISS Item)]] (T32)
*[[CRRT (TISS Item)]] (T33) 	
*[[Peritoneal dialysis (TISS Item)]] (T34)

=== Dialysis requiring Dxs ===
<!-- not using [[Concept:Acute renal failure]]: because it includes too much, mild version might not need dialysis -->
* [[Kidney, acute renal failure NOS]]
* [[Kidney, acute renal failure, postprocedural]]
* [[Kidney, acute tubular necrosis (ATN)]]

=== Dialysis qualifying Dxs ===
all [[#Dialysis requiring Dxs]] plus: 
[[Concept:Chronic Kidney Disease]]: 
{{#ask: [[Concept:Chronic Kidney Disease]]
|default=none found
|format=UL
|limit=10}}
*[[Hyperkalemia]]
*[[Congestive heart failure with pulmonary edema]]
*[[Fluid overload]]
*Metabolic acidosis: [[Acidosis, NOS]] or [[Kidney, renal tubular acidosis (RTA, all types)]]
*Drug overdoses and poisonings -- the main ones are:
** Aspirin & other salicylates --   [[Aspirin or other salicylate or NSAID, overdose/toxicity]]
** Valproic acid, carbemazepine (Tegretol), phenytoin (Dilantin), barbiturates --     [[Antiseizure drug NOS, overdose/toxicity]]
** Metformin -- [[Insulin or other antidiabetes drug, overdose/toxicity]] 
** Lithium -- [[Psychiatric drug NOS, adverse effect]]
** Theophylline -- [[Drug or biological substance/agent NOS, overdose/toxicity]]
** Alcohols -- [[Alcohol (ethanol), poisoning by non-pharmaceuticals]] or [[Toxic alcohols, poisoning by non-pharmaceuticals]]
** Diltiazem -- [[Calcium channel blocker, overdose/toxicity]]
** Occasionally a few others (rare)

== Checks ==
=== Has [[#Dialysis requiring Dxs]] but no [[#Dialysis TISS Items]] ===
If meets following the entry is an error: 
* ICU patient 
* LOS>3 
* at least one [[#Dialysis requiring Dxs]]
* '''doesn't have''' any [[#Dialysis TISS Items]]

=== Has [[#Dialysis TISS Items]] but no [[#Dialysis qualifying Dxs]] ===
If meets following the entry is an error: 
* at least one of [[#Dialysis TISS Items]]
* '''doesn't have''' one [[#Dialysis qualifying Dxs]]

== Reality check ==
{{Discuss | who = Julie| question =  
*AG REPLY -- This is challenging since not everyone with either ARF or CRF gets dialysis AND not everybody who gets dialysis has renal failure -- e.g. dialysis is also occasionally used for drug overdoses, volume overload, and a very few other things.}}

== Related articles ==
{{Related Articles}}

[[Category: TISS28 checks]]
[[Category: ICD10 Dx check]]