Check Renal Tasks: Difference between revisions

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* ~~Dialysis~~ task is required if all of the following are true:

{{LegacyContent

|explanation=Collection of [[Tasks Elements]] was discontinued as part of move to [[ICD10]]/[[CCI]].

|content=

== Review for ICD10/CCI ==

Allan-Have you heard back from Nick about whether tasks and special [[cross check]]s will still be required in ICD10?

== dx implies task ==

If a medicine patient has LOS >= 3

* HD or PD task is required if all of the following are true:

** one of the following '''is''' present:

*** comorbid [[CRF - Chronic Renal Failure|CRF]]

*** diagnosis [[ARF (Diagnosis)|ARF]]

** LOS >= 3

** [[Renal Transplant]] (80504 or 80505) is '''not''' present

***you can have a renal transplant in comorbid and HD or PD task can still be checked as a patient with a failed renal transplant can require dialysis again [[User:Lkaita|Lisa Kaita]] 12:04, 2017 April 26 (CDT)

=== which dxs?===

* 350 [[ARF (Diagnosis)]]

* 351 [[CRF - Chronic Renal Failure]] as comorbid

== task implies dx ==

If a medicine patient has LOS >= 3 and has a HD or PD task then must have one of the following dxs:

* comorbid [[CRF - Chronic Renal Failure|CRF]]

* diagnosis [[ARF (Diagnosis)|ARF]]

=== which dxs?===

* 350 [[ARF (Diagnosis)]]

* 351 [[CRF - Chronic Renal Failure]]

==Questions prior to implementing ==

=== excluding community hospitals ===

Apparently neither HD nor PD is done at community hospitals.

* Dialysis Task must never be marked for

** GRA N3/N5/W3

** VIC N5/S3/S4/S5

* Since we only check patients with LOS>3, do we need to consider this? If a pt with CRF/ARF is in hospital longer than 3 days would dialysis not need to be accommodated? IE, would the patient then not need to be sent to a different hospital that can dialyze? Ttenbergen 21:02, 2014 April 30 (CDT)

**there are exceptions: If Grace and VIC Med send patient for dialysis to HSC or STB, then they return back to medicine bed, TASK will be marked with dialysis for their site. (As per Trish, I think)

*** Except those, community sites should not have dialysis task, right? [[User:Ttenbergen|Ttenbergen]] 17:14, 27 October 2008 (CDT)

** So these locations would not admit patients who are, say, on home peritoneal dialysis?

*** DC never encounter such case

****at the Grace those patients with CRF ie on HD or PD are not admitted here, we have had one case where a patient was transferred to HSC for acute HD and then transferred back to the Grace, this was many years ago, not sure about the VGH[[User:Lkaita|Lisa Kaita]] 12:20, 2017 April 26 (CDT)

~~== Discussion ==~~

Would this be a proper summary for the above:

~~Instructions from Trish~~ are:

* HD and PD are not done at community hospitals

* if ~~community Hosp and admit or complication~~ is ~~ARF and patient discharged to teaching (HSC or STB), and task not marked, this is okay, because community~~ sent to ~~teaching~~ for ~~dialysis. (Trish)~~

* task might still be coded if pt is sent to other site for it

** ~~If LOS>3days this would be problematic to the patient~~, ~~would~~ it ~~not. If the time restriction still stands~~, ~~then the LOS check above already takes care of this. Are you sure you want patients with 351 who are not dialyzed~~ for ~~more than~~ 3 days ~~not to be flagged? Ttenbergen 14:14, 29 October 2008 (CDT)~~

* the check would apply for GRA/VIC just like other sites:

** if pt needs PD/HD, they need it, so they won't be kept for >3 days without

=== palliation? ===

* Could any of (e) or (f) be OK if the patient is palliative? (Tina)

** Yes. Found cases of palliative with dialysis. (Julie)

*** Yes, but could a palliative patient not also arrive and not get dialysis even if they are CRF? (Tina)

**** yes we have cases where this has occurred, ie CRF in comorbid but no dialysis task entered if not dialyzed during the admission secondary to palliation[[User:Lkaita|Lisa Kaita]] 12:25, 2017 April 26 (CDT)

***** Would all the pts like this have either Palliation or Comfort Care marked? That would mean I could exclude them from the check "if you have dx you must have task"...

*Problem/Question: if community Hosp with DX ARF and patient sent to teaching hosp and the DX is not ~~ARF and no dialysis done, how does Julie want to handle?~~

=== [[Renal Transplant]] not present ===

** how could the dx for an ARF patient not be ~~ARF? Please clarify..~~.[[User:~~Ttenbergen~~|~~Ttenbergen~~]] 14:14, 29 October 2008 (CDT)

If 351 in comorbid Dx AND Admit DX 1 = 893 (pre op admission) AND complication = 805-4 or 805-5 then TASK DIALYSIS should not be marked.-[[User:PTorres|PTorres]] 16:06, 21 October 2008 (CDT). Not sure if Julie applies this detail or not.[[User:TOstryzniuk|Trish Ostryzniuk]] 11:45, 2014 February 4 (CST)

***because he is really an ARI.

* No dialysis prior to transplant while waiting in hospital? No dialysis after transplant if things go wrong? That restriction could lead to errors being listed. Ttenbergen 12:37, 2014 May 5 (CDT)

***physicians are not consistent in their definition of ARF vs ARI vs CRF or ~~acute on chronic renal failure. I am~~ not ~~sure I need to repeat this story here yet AGAIN. I believe this was discussed under renal section on WIKI~~. [[User:TOstryzniuk|~~TOstryzniuk~~]] 17:42, ~~29 October 2008~~ (~~CDT~~)

**** If physicians are inconsistent, and we are unable to ~~give the DCs instructions that remove all ambiguity, then it seems to make no sense to automate checking for this, does it~~? ~~If Julie has no time for the wiki, and you still want~~ to ~~concentrate on the first three questions first, then you might want to talk with her to confirm that we should just ignore this~~. ~~[[User:~~Ttenbergen~~|Ttenbergen]] 14~~:15, ~~30 October 2008~~ (CDT)

== ~~Administration~~ ==

== Implementation ==

Hardcoded in query Check_Renal_Tasks in [[CCMDB.~~mdb~~]].

Hardcoded in query Check_Renal_Tasks in [[CCMDB.accdb]].

'''This will need to be changed!'''

== Start Date ==

TBA, once discussion is resolved

TBA, once discussion above is resolved

== Status ==

being implemented once discussion is resolved

== ~~Related Articles~~ ==

== See also ==

*[[Renal Coding Considerations]]

* [[Renal Coding Considerations (old)]]

* [[Dialysis Tasks]]

== Related articles ==

[[Category: ~~IT Instructions~~]]

[[Category:ICD10 Dx check]]

[[Category: Data ~~Cleaner.mdb~~]]

[[Category:Data Collection Guide]]

[[Category: ~~Data Collection Guide~~]]

[[Category:Task Elements]]

}}

@@ Line 1: / Line 1: @@
-* Dialysis task is required if all of the following are true:
+{{LegacyContent
+|explanation=Collection of [[Tasks Elements]] was discontinued as part of move to [[ICD10]]/[[CCI]].
+|content=
+== Review for ICD10/CCI ==
+Allan-Have you heard back from Nick about whether tasks and special [[cross check]]s will still be required in ICD10?
+== dx implies task ==
+If a medicine patient has LOS >= 3
+* HD or PD task is required if all of the following are true:
 ** one of the following '''is''' present:
 *** comorbid [[CRF - Chronic Renal Failure|CRF]]
 *** diagnosis [[ARF (Diagnosis)|ARF]]
-** LOS >= 3
 ** [[Renal Transplant]] (80504 or 80505) is '''not''' present
+***you can have a renal transplant in comorbid and HD or PD task can still be checked as a patient with a failed renal transplant can require dialysis again [[User:Lkaita|Lisa Kaita]] 12:04, 2017 April 26 (CDT)
+=== which dxs?===
+* 350 [[ARF (Diagnosis)]]
+* 351 [[CRF - Chronic Renal Failure]] as comorbid
+== task implies dx ==
+If a medicine patient has LOS >= 3 and has a HD or PD task then must have one of the following dxs:
+* comorbid [[CRF - Chronic Renal Failure|CRF]]
+* diagnosis [[ARF (Diagnosis)|ARF]]
+=== which dxs?===
+* 350 [[ARF (Diagnosis)]]
+* 351 [[CRF - Chronic Renal Failure]]
+==Questions prior to implementing ==
+=== excluding community hospitals ===
+Apparently neither HD nor PD is done at community hospitals.
 * Dialysis Task must never be marked for
 ** GRA N3/N5/W3
 ** VIC N5/S3/S4/S5
+* Since we only check patients with LOS>3, do we need to consider this? If a pt with CRF/ARF is in hospital longer than 3 days would dialysis not need to be accommodated? IE, would the patient then not need to be sent to a different hospital that can dialyze? Ttenbergen 21:02, 2014 April 30 (CDT)
+**there are exceptions: If Grace and VIC Med send patient for dialysis to HSC or STB, then they return back to medicine bed, TASK will be marked with dialysis for their site. (As per Trish, I think)
+*** Except those, community sites should not have dialysis task, right? [[User:Ttenbergen|Ttenbergen]] 17:14, 27 October 2008 (CDT)
+** So these locations would not admit patients who are, say, on home peritoneal dialysis?
+*** DC never encounter such case
+****at the Grace those patients with CRF ie on HD or PD are not admitted here, we have had one case where a patient was transferred to HSC for acute HD and then transferred back to the Grace, this was many years ago, not sure about the VGH[[User:Lkaita|Lisa Kaita]] 12:20, 2017 April 26 (CDT)
-== Discussion ==
+Would this be a proper summary for the above:
-Instructions from Trish are:
+* HD and PD are not done at community hospitals
-* if community Hosp and admit or complication is ARF and patient discharged to teaching (HSC or STB), and task not marked, this is okay, because community sent to teaching for dialysis. (Trish)
+* task might still be coded if pt is sent to other site for it
-** If LOS>3days this would be problematic to the patient, would it not. If the time restriction still stands, then the LOS check above already takes care of this. Are you sure you want patients with 351 who are not dialyzed for more than 3 days not to be flagged? Ttenbergen 14:14, 29 October 2008 (CDT)
+* the check would apply for GRA/VIC just like other sites:
+** if pt needs PD/HD, they need it, so they won't be kept for >3 days without
+=== palliation? ===
+* Could any of (e) or (f) be OK if the patient is palliative? (Tina)
+** Yes. Found cases of palliative with dialysis. (Julie)
+*** Yes, but could a palliative patient not also arrive and not get dialysis even if they are CRF? (Tina)
+**** yes we have cases where this has occurred, ie CRF in comorbid but no dialysis task entered if not dialyzed during the admission secondary to palliation[[User:Lkaita|Lisa Kaita]] 12:25, 2017 April 26 (CDT)
+***** Would all the pts like this have either Palliation or Comfort Care marked? That would mean I could exclude them from the check "if you have dx you must have task"...
-*Problem/Question: if community Hosp with DX ARF and patient sent to teaching hosp and the DX is not ARF and no dialysis done, how does Julie want to handle?
+=== [[Renal Transplant]] not present ===
-** how could the dx for an ARF patient not be ARF? Please clarify...[[User:Ttenbergen|Ttenbergen]] 14:14, 29 October 2008 (CDT)
+If 351 in comorbid Dx AND Admit DX 1 = 893 (pre op admission) AND complication = 805-4 or 805-5 then TASK DIALYSIS should not be marked.-[[User:PTorres|PTorres]] 16:06, 21 October 2008 (CDT). Not sure if Julie applies this detail or not.[[User:TOstryzniuk|Trish Ostryzniuk]] 11:45, 2014 February 4 (CST)
-***because he is really an ARI.
+* No dialysis prior to transplant while waiting in hospital? No dialysis after transplant if things go wrong? That restriction could lead to errors being listed. Ttenbergen 12:37, 2014 May 5 (CDT)
-***physicians are not consistent in their definition of ARF vs ARI vs CRF or acute on chronic renal failure.  I am not sure I need to repeat this story here yet AGAIN.  I believe this was discussed under renal section on WIKI. [[User:TOstryzniuk|TOstryzniuk]] 17:42, 29 October 2008 (CDT)
-**** If physicians are inconsistent, and we are unable to give the DCs instructions that remove all ambiguity, then it seems to make no sense to automate checking for this, does it? If Julie has no time for the wiki, and you still want to concentrate on the first three questions first, then you might want to talk with her to confirm that we should just ignore this. [[User:Ttenbergen|Ttenbergen]] 14:15, 30 October 2008 (CDT)
-== Administration ==
+== Implementation ==
-Hardcoded in query Check_Renal_Tasks in [[CCMDB.mdb]].
+Hardcoded in query Check_Renal_Tasks in [[CCMDB.accdb]].
+'''This will need to be changed!'''
 == Start Date ==
-TBA, once discussion is resolved
+TBA, once discussion above is resolved
 == Status ==
 being implemented once discussion is resolved
-== Related Articles ==
+== See also ==
-*[[Renal Coding Considerations]]
+* [[Renal Coding Considerations (old)]]
+* [[Dialysis Tasks]]
+== Related articles ==
+{{Related Articles}}
-[[Category: IT Instructions]]
+[[Category:ICD10 Dx check]]
-[[Category: Data Cleaner.mdb]]
+[[Category:Data Collection Guide]]
-[[Category: Data Collection Guide]]
+[[Category:Task Elements]]
+}}