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Query check CCI ICD10 Dialysis no Dx: Difference between revisions

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[[TISS28]]
{{Data Integrity Check
*32 Intermittent Hemodialysis (even if pt goes to dialysis unit)
|DIC_summary=If a profile has one of the [[#Dialysis CCI Items]] there should also be one of the [[#Dialysis qualifying Dxs]].
*33 CRRT
|DIC_related_concepts= Peritoneal dialysis (TISS Item); CRRT (TISS Item); Intermittent hemodialysis (TISS Item); {{#ask: [[Concept:Acute renal failure]]|default=none found|format=plainlist|link=none|limit=100|sep=;}}; Kidney, acute renal failure, postprocedural;Kidney, acute renal failure NOS;Kidney, acute tubular necrosis (ATN);Hyperkalemia, severe or symptomatic;Congestive heart failure with pulmonary edema;Fluid overload;Acidosis, NOS;Kidney, renal tubular acidosis (RTA, all types);Aspirin or other salicylate or NSAID, overdose/toxicity;Antiseizure drug NOS, overdose/toxicity; Insulin or other antidiabetes drug, overdose/toxicity;Psychiatric drug NOS, overdose/toxicity;Drug or biological substance/agent NOS, overdose/toxicity;Alcohol (ethanol), poisoning;Toxic alcohols, poisoning;Calcium channel blocker, overdose/toxicity
*34 Peritoneal Dialysis
|DIC_firmness=hard check
|DIC_timing=complete
|DIC_coding=query ''check_CCI_ICD10_Dialysis_no_Dx''
|DIC_implementation_date=2021-10-27
|DIC_status=implemented
|DIC_app=CCMDB.accdb
}}


== CRF/ARF vs [[TISS28]] items 32, 33, 34 ==
If a profile has one of the [[#Dialysis CCI Items]] there should also be one of the [[#Dialysis qualifying Dxs]].
=== dx implies TISS ===
Any
*ICU patient
*with LOS>3
*and dxs (350, 351, 352, 355, 356, 398, 450-499, 327, 357)
*who doesn't have (T33/34/35) in TISS28 is an error.


=== TISS implies dx ===
=== Dialysis CCI Items ===
Any
*{{ CCIWithCode | CRRT (TISS Item)}}
*ICU patient
*{{ CCIWithCode | Peritoneal dialysis (TISS Item)}}
*with LOS>3
*{{ CCIWithCode | Intermittent hemodialysis (TISS Item)}}
*and (T33/34/35) in TISS28
*{{ CCIWithCode | PD (Peritoneal dialysis)}}
*who doesn't have one of dxs (350, 351, 352, 355, 356, 398, 450-499, 327, 357) is an error.
*{{ CCIWithCode | HD (Hemodialysis)}}
*{{ CCIWithCode | CRRT (incl volume removal via PRISMA device)}}


== Reality check ==
=== Dialysis qualifying Dxs ===
*{{ICD10WithCode | Chronic kidney disease (chronic renal insufficiency, uremia) Stage 1, GFR GT 90}}
*{{ICD10WithCode | Chronic kidney disease (chronic renal insufficiency, uremia) Stage 2, GFR 60-89}}
*{{ICD10WithCode | Chronic kidney disease (chronic renal insufficiency, uremia) Stage 3, GFR 30-59}}
*{{ICD10WithCode | Chronic kidney disease (chronic renal insufficiency, uremia) Stage 4, GFR 15-29}}
*{{ICD10WithCode | Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15}}
*{{ICD10WithCode | Chronic kidney/renal disease, NOS (stage unspecified)}}
*{{ICD10WithCode | Kidney, renal failure/insufficiency/uremia, unspecified as acute or chronic}}
*{{ICD10WithCode | Kidney, acute renal failure, postprocedural}}
*{{ICD10WithCode | Kidney, acute renal failure NOS}}
*{{ICD10WithCode | Kidney, acute tubular necrosis (ATN)}}
*{{ICD10WithCode | Hyperkalemia, severe or symptomatic}}
*{{ICD10WithCode | Congestive heart failure with pulmonary edema}}
*{{ICD10WithCode | Fluid overload}}
*Metabolic acidosis:
**{{ICD10WithCode | Acidosis, NOS}}
**{{ICD10WithCode | Kidney, renal tubular acidosis (RTA, all types)}}
*Drug overdoses and poisonings -- the main ones are:
** Aspirin & other salicylates -- {{ICD10WithCode | Aspirin or other salicylate or NSAID, overdose/toxicity}}
** Valproic acid, carbemazepine (Tegretol), phenytoin (Dilantin), barbiturates -- {{ICD10WithCode | Antiseizure drug NOS, overdose/toxicity}}
** Metformin -- {{ICD10WithCode | Insulin or other antidiabetes drug, overdose/toxicity}}
** Lithium -- {{ICD10WithCode | Psychiatric drug NOS, overdose/toxicity}}
** Theophylline -- {{ICD10WithCode | Drug or biological substance/agent NOS, overdose/toxicity}}
** Alcohols --
*** {{ICD10WithCode | Alcohol (ethanol), poisoning}}
*** {{ICD10WithCode | Toxic alcohols, poisoning}}
** Diltiazem -- {{ICD10WithCode | Calcium channel blocker, overdose/toxicity}}
** Occasionally a few others (rare)


* Collectors can you see a scenario where this would not be an error? If not, this could be added to [[Change Priorities]]. Ttenbergen 20:17, 2014 April 30 (CDT){{Potential Change}}
Allan confirmed that we would not need to add covid because if used in that context, renal failure would also be coded.
**codes 350 through 355 all pertain to ARF, however the other remaining codes are not correct, as they do not necessarily mean that dialysis is started [[User:Lkaita|Lisa Kaita]] 12:03, 2017 April 25 (CDT) 
=== ARF transfer considerations ===
* When a pt starts out in a community hospital and is given a diagnosis of ARF by the doctors, please do not code ARF unless dialysis is started there.  Code ATN or ARI instead. If the pt is transferred to another center to start dialysis, the collector there will code ARF.  When a pt with ARF from a tertiary hospital is transferred to a community hospital and no dialysis is needed there, the data collectors at the community hospital should not be coding ARF because the renal failure is resolving. They can code ARI. This is my understanding.  Trish please let me know if this is the way you also see it.  I believe the above information for integrity checks is wrong. --[[User:LKolesar|LKolesar]] 13:41, 20 July 2011 (CDT)


== Short stay patients, incl community hospitals==
== Log ==
CRF/ARF patients may not receive dialysis if they are only there for a short time. That led to false=positives for the check, especially in community hospitals, so the restriction of "LOS>3" was added.
* 2024-04-24 - changed from [[Psychiatric drug NOS, adverse effect]] to [[Psychiatric drug NOS, overdose/toxicity]] [[User:Ttenbergen|Ttenbergen]] 09:50, 2024 April 24 (CDT)


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


[[Category: TISS28 Checks]]
[[Category:TISS28 check]]
[[Category:ICD10 Dx check]]
[[Category:Dialysis]]
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