CCMDB Wiki

Combined ICD10 codes: Difference between revisions

← Older edit
Agarland (talk | contribs)
CCMDB_legit, approved, Administrators
3,312 edits
m Text replacement - "[[Category: " to "[[Category:"
 
(16 intermediate revisions by 4 users not shown)
Line 1: Line 1:
To code some diagnoses as part of [[ICD10 collection]], several lines of entries in the [[Patient viewer tab ICD10]] need to be grouped together.
To code some diagnoses as part of [[ICD10 collection]], several lines of entries in the [[Patient Viewer Tab ICD10]] need to be grouped together.


To group diagnoses together, use the same [[Dx Priority]] for all of them.
To group diagnoses together, use the same [[Dx Priority]] for all of them.
Line 24: Line 24:
*link codes to “create” an entity for which no separate ICD10 code exists, such as retroperitoneal hemorrhage,  
*link codes to “create” an entity for which no separate ICD10 code exists, such as retroperitoneal hemorrhage,  
*to connect cause with effect(s), e.g. a trauma combined with all the separate fractured bones.
*to connect cause with effect(s), e.g. a trauma combined with all the separate fractured bones.
{{Discuss | who = Allan| question =
* See [https://ccmdb.kuality.ca/index.php?title=Task_Team_Meeting_-_Rolling_Agenda_and_Minutes_2019#ICU_Database_Task_Group_Meeting_.E2.80.93_July_16.2C_2019  July 16.19 ICU TASK meeting minutes.
*Julie and Allan to review.}}


=== Q&A: Just How Far Should You Go in Linking Cause and Effect Diagnoses? ===
=== Q&A: Just How Far Should You Go in Linking Cause and Effect Diagnoses? ===
*If it is abundantly clear that A caused B that caused C and all of A, B, and C are all Admit or all Acquired, then combine them together
*If it is abundantly clear that A caused B that caused C and all of A, B, and C are all Admit or all Acquired, then combine them together.  '''If it is possible but not COMPLETELY clear that the items are causally linked, then do NOT combine them'''
**Example:  Stabbed --> lots of internal organ injuries from the stabbing --> big blood loss ---> hemorrhagic shock --> cardiac arrest.
*Example#1:  Stabbed --> lots of internal organ injuries from the stabbing --> big blood loss ---> hemorrhagic shock --> cardiac arrest.
*If it is possible but not completely clear that the items are causally linked, then do NOT combine them.
*Example #2:  Chemotherapy --> N/V as an adverse effect --> dehydration --> orthostatic syncope.  But Chemo also caused drug-induced thrombocyotopenia as an adverse effect.  And Chemo also caused Skin rash as an adverse effect.  And all were present on admission (or all occurred after admission and so are Acquired diagnoses).  In this case we have the Chemo causing problems in 3 separate pathways. Here again, we want you to combine all 6 codes together with the same priority number.  
*What about when A causes B in a causal way, but also causes C and D in causal ways that are NOT related to each other?
**Example:  Chemotherapy --> N/V.  But Chemo also caused drug-induced thrombocyotopenia.  And Chemo also caused Skin rash.  In this case we have the Chemo causing problems in 3 separate pathways. What we want you to do when there is more than one separate such pathway is to choose the single one of them that is "worst" (e.g. the thrombocytopenia) to combinewith the same priority as the Chemo, and the other pathways (i.e. N/V and Rash) are listed separately, with separate priority numbers.
     Rash
     Rash
     /\
     /\
     |
     |
     |
     |
     Chemo ---> N/V  
     Adverse effect of chemo ---> N/V --> dehydration --> syncope
     |
     |
     |
     |
     \/
     \/
     Drug-induced thrombocytopenia
     Drug-induced thrombocytopenia
*What about when there's a diagnosis (A) which is a known risk factor for another diagnosis (B).  But in fact B is influenced by other things, not only A.  In this case, do NOT combine A and B. 
**Example:  Diabetes is a risk factor for MI.  But so are hypertension, hyperlipidemia and genetic factors.  So here do NOT combine the MI with the diabetes (or the hypertension or hyperlipidemia) because it's not a direct arrow from diabetes to MI.  But of course, do code all of these diagnoses that are present (in the example that means code the diabetes and the MI, and hypertension if present, etc).
Thanks for clarifying the diabetes issue. [[User:DPageNewton|DPageNewton]] 12:21, 2019 October 10 (CDT)


=== Primary Admit Diagnosis in Combined Codes  ===
=== Primary Admit Diagnosis in Combined Codes  ===
Line 68: Line 67:


== CCMDB Data Integrity Checks ==
== CCMDB Data Integrity Checks ==
Some codes always need to be combined with one or more others. See [[Minimum combined codes]] for details.
Some codes always need to be combined with one or more others.  


Most infection codes require combined-coding of a pathogen (some have it implied, like [[Mumps]]), and some disorders can have a pathogen if their cause is infectious. See [[Bug required]] for details.
Most infection codes require combined-coding of a pathogen (some have it implied, like [[Mumps]]), and some disorders can have a pathogen if their cause is infectious. See [[Bug required]] for details.
Line 81: Line 80:
{{Related Articles}}
{{Related Articles}}


[[Category: ICD10]]
[[Category:ICD10]]
[[Category: ICD10/CCI Conversion]]
[[Category:ICD10/CCI Conversion]]
Retrieved from "https://ccmdb.kuality.ca/index.php?title=Combined_ICD10_codes"