Guideline for coding organ donation after death: Difference between revisions

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*Donation after cardiac death (DCD) is where a donor who is not brain dead is dependent on life support and the family has decided to withdraw care. When the patient's heart stops beating, the organs are then recovered in the operating room. Withdrawal of care, and death usually will occur while still in the ICU.

*For a patient who dies while in the ICU and goes on to donate organs, code the [[Dispo]] as '''Died - to OR''', with the time and date of the patient's death. These patients should have an acquired diagnosis of [[Organ donor (organ/tissue donation by the donor)]], with the corresponding date of the time of withdrawal of care. These patients will not have a transfer ready date, so the checkbox should be checked off. Patients that go on to donate organs should not have an acquired [[Palliative care]] diagnosis.

*For a patient who is a potential organ donor, but does not die within the time required for organ retrieval, ~~then~~ do NOT include [[Organ donor (organ/tissue donation by the donor)]] as an acquired diagnosis. The Transfer Ready DtTm for these patients will be when they are deemed unsuitable for organ retrieval. [[Palliative care]] ~~should be added as an acquired diagnosis if there is an order for making the patient "~~ACP C"

*For a patient who is a potential organ donor, but does not die within the time required for organ retrieval, do NOT include [[Organ donor (organ/tissue donation by the donor)]] as an acquired diagnosis. The [[Transfer Ready DtTm]] for these patients will be when they are deemed unsuitable for organ retrieval. Consider the usual rules about [[Palliative care]] and [[ACP-C]] coding.

=== MAID with Organ Donation ===

=== [[MAID]] with Organ Donation ===

*Medical Assistance in Dying ([[MAID]]) ~~is where a person who undergoes MAID has made~~ arrangements in advance for organ harvesting after death.

*A person undergoing Medical Assistance in Dying ([[MAID]]) may be able to make arrangements in advance for organ harvesting after death.

*If a MAID patient who dies in ICU or ward becomes a (planned) donor, then the dispo is '''Died - to OR''', i.e. no need to ~~bring up~~ brain death. If MAID is provided in the OR, then handle this like DCD (see above) BUT also do ~~list~~ the ~~ICD10~~ code for MAID as ~~an acquired dx in ICU~~

*If a MAID patient who dies in ICU or ward becomes a (planned) donor, then the dispo is '''Died - to OR''', i.e. no need to code [[brain death]]. If MAID is provided in the OR, then handle this like DCD (see above) BUT also code [[Medical Assistance In Dying]] as an [[Acquired Diagnosis]] in ICU.

{{Discuss | For a patient who intend to be an organ donor and died in the unit or ward but the organ donor did not happen for some reason (e.g. family changed their mind, or some other circumstance occurred, and they did not end up going to the OR), do we still need to code [[Organ donor (organ/tissue donation by the donor)]] in admit or acquired? maybe not and the Dispo entry is just - '''Died to morgue''' ? Or if we want to keep the organ donor code, we need a code telling it did not happen, is that possible? --[[User:JMojica|JMojica]] 16:58, 18 November 2025 (CST)

Another scenario - For a patient who has an acquired diagnosis of [[Organ donor (organ/tissue donation by the donor)]] and [[brain death]] and the harvesting done during the same ICU admission and did not go to OR, then the dispo is '''Died to morgue''' , is this correct? --[[User:JMojica|JMojica]] 16:58, 18 November 2025 (CST)

* Question is under the MAID heading in here but does not necessarily seem to be related to MAID... or is it? [[User:Ttenbergen|Ttenbergen]] 23:20, 18 November 2025 (CST)

* I have a feeling this question comes with context - what were you looking for? [[User:Ttenbergen|Ttenbergen]] 23:20, 18 November 2025 (CST)

** the two items listed here are general questions about organ donor and how to know if the donor happened or not. i just inserted the discussions after the MAID but not meant to be related to MAID. Sorry, I notice how the two comments came out , one with a box and another under it. I tried to change but unsuccessful so I leave them as is. The main goal is to add them to the instruction if making sense. --[[User:JMojica|JMojica]] 09:05, 19 November 2025 (CST)

}}

== How they are treated in linking ==

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 *Donation after cardiac death (DCD) is where a donor who is not brain dead is dependent on life support and the family has decided to withdraw care. When the patient's heart stops beating, the organs are then recovered in the operating room. Withdrawal of care, and death usually will occur while still in the ICU.
 *For a patient who dies while in the ICU and goes on to donate organs, code the [[Dispo]] as '''Died - to OR''', with the time and date of the patient's death. These patients should have an acquired diagnosis of [[Organ donor (organ/tissue donation by the donor)]], with the corresponding date of the time of withdrawal of care. These patients will not have a transfer ready date, so the checkbox should be checked off. Patients that go on to donate organs should not have an acquired [[Palliative care]] diagnosis.
-*For a patient who is a potential organ donor, but does not die within the time required for organ retrieval, then do NOT include [[Organ donor (organ/tissue donation by the donor)]] as an acquired diagnosis. The Transfer Ready DtTm for these patients will be when they are deemed unsuitable for organ retrieval. [[Palliative care]] should be added as an acquired diagnosis if there is an order for making the patient "ACP C"
+*For a patient who is a potential organ donor, but does not die within the time required for organ retrieval, do NOT include [[Organ donor (organ/tissue donation by the donor)]] as an acquired diagnosis. The [[Transfer Ready DtTm]] for these patients will be when they are deemed unsuitable for organ retrieval. Consider the usual rules about [[Palliative care]] and [[ACP-C]] coding.
-=== MAID with Organ Donation ===
+=== [[MAID]] with Organ Donation ===
-*Medical Assistance in Dying ([[MAID]]) is where a person who undergoes MAID has made arrangements in advance for organ harvesting after death.
+*A person undergoing Medical Assistance in Dying ([[MAID]]) may be able to make arrangements in advance for organ harvesting after death.
-*If a MAID patient who dies in ICU or ward becomes a (planned) donor, then the dispo is '''Died - to OR''', i.e. no need to bring up brain death.  If MAID is provided in the OR, then handle this like DCD (see above) BUT also do list the ICD10 code for MAID as an acquired dx in ICU
+*If a MAID patient who dies in ICU or ward becomes a (planned) donor, then the dispo is '''Died - to OR''', i.e. no need to code [[brain death]]. If MAID is provided in the OR, then handle this like DCD (see above) BUT also code [[Medical Assistance In Dying]] as an [[Acquired Diagnosis]] in ICU.
+{{Discuss | For a patient who intend to be an organ donor and died in the unit or ward but the organ donor did not happen for some reason (e.g. family changed their mind, or some other circumstance occurred, and they did not end up going to the OR),  do we still need to code [[Organ donor (organ/tissue donation by the donor)]] in admit or acquired? maybe not and the  Dispo entry is just - '''Died to morgue''' ?  Or if we want to keep the organ donor code, we need a code telling it did not happen, is that possible? --[[User:JMojica|JMojica]] 16:58, 18 November 2025 (CST)
+Another scenario - For a patient who has an acquired diagnosis of [[Organ donor (organ/tissue donation by the donor)]] and [[brain death]] and the harvesting done during the same ICU admission and did not go to OR, then the dispo is '''Died to morgue''' , is this correct? --[[User:JMojica|JMojica]] 16:58, 18 November 2025 (CST)
+* Question is under the MAID heading in here but does not necessarily seem to be related to MAID... or is it? [[User:Ttenbergen|Ttenbergen]] 23:20, 18 November 2025 (CST)
+* I have a feeling this question comes with context - what were you looking for? [[User:Ttenbergen|Ttenbergen]] 23:20, 18 November 2025 (CST)
+** the two items listed here are general questions about organ donor and how to know if the donor happened or not.   i just inserted the discussions after the MAID but not meant to be related to MAID. Sorry, I notice how the two comments came out , one with a box and another under it. I tried to change but unsuccessful so I leave them as is.  The main goal is to add them to the instruction if making sense. --[[User:JMojica|JMojica]] 09:05, 19 November 2025 (CST)
+}}
 == How they are treated in linking ==