Query check CCI ICD10 Dialysis no Dx: Difference between revisions

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{{Data Integrity Check
{{Data Integrity Check
|DIC_summary=If there is a [[TISS28]] entry for Hemodialysis there should be a corresponding Dx.
|DIC_summary=If a profile has one of the [[#Dialysis CCI Items]] there should also be one of the [[#Dialysis qualifying Dxs]].
|DIC_related_concepts=Intermittent hemodialysis (TISS Item); Peritoneal dialysis (TISS Item); CRRT (TISS Item); ARF (Diagnosis); Pt Monitored while on Dialysis
|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
|DIC_firmness=hard check
|DIC_firmness=hard check
|DIC_timing=complete
|DIC_timing=complete
|DIC_status=needs review
|DIC_coding=query ''check_CCI_ICD10_Dialysis_no_Dx''
|DIC_LProblem=No
|DIC_implementation_date=2021-10-27
|DIC_app=Centralized data front end.accdb
|DIC_status=implemented
|DIC_app=CCMDB.accdb
}}
}}
If there is a [[TISS28]] entry for Hemodialysis there should be a corresponding Dx.


=== Dialysis TISS Items ===
If a profile has one of the [[#Dialysis CCI Items]] there should also be one of the [[#Dialysis qualifying Dxs]].
*[[Intermittent hemodialysis (TISS Item)]] (T32)
*[[CRRT (TISS Item)]] (T33)
*[[Peritoneal dialysis (TISS Item)]] (T34)


=== Dialysis requiring Dxs ===
=== Dialysis CCI Items ===
*[[ARF (Diagnosis)]](350)
*{{ CCIWithCode | CRRT (TISS Item)}}
*[[Pt Monitored while on Dialysis]] (398)
*{{ CCIWithCode | Peritoneal dialysis (TISS Item)}}
[[Concept:Acute renal failure]]:
*{{ CCIWithCode | Intermittent hemodialysis (TISS Item)}}
{{#ask: [[Concept:Acute renal failure]]
*{{ CCIWithCode | PD (Peritoneal dialysis)}}
|default=none found
*{{ CCIWithCode | HD (Hemodialysis)}}
|format=UL
*{{ CCIWithCode | CRRT (incl volume removal via PRISMA device)}}
|limit=10}}


=== Dialysis qualifying Dxs ===
=== Dialysis qualifying Dxs ===
all [[#Dialysis requiring Dxs]] plus:
*{{ICD10WithCode | Chronic kidney disease (chronic renal insufficiency, uremia) Stage 1, GFR GT 90}}
*[[CRF - Chronic Renal Failure]](351) (not mandatory because what if they die/discharge before dialysis?)  
*{{ICD10WithCode | Chronic kidney disease (chronic renal insufficiency, uremia) Stage 2, GFR 60-89}}
[[Concept:Chronic Kidney Disease]]:  
*{{ICD10WithCode | Chronic kidney disease (chronic renal insufficiency, uremia) Stage 3, GFR 30-59}}
{{#ask: [[Concept:Chronic Kidney Disease]]
*{{ICD10WithCode | Chronic kidney disease (chronic renal insufficiency, uremia) Stage 4, GFR 15-29}}
|default=none found
*{{ICD10WithCode | Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15}}
|format=UL
*{{ICD10WithCode | Chronic kidney/renal disease, NOS (stage unspecified)}}
|limit=10}}
*{{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)


== Checks ==
Allan confirmed that we would not need to add covid because if used in that context, renal failure would also be coded.
=== 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:
* ICU patient
* LOS>3
* at least one of [[#Dialysis TISS Items]]
* '''doesn't have''' one [[#Dialysis qualifying Dxs]]
 
=== Has a Dialysis CCI ===
* CCI:
**[[Peritoneal dialysis]]
**[[Hemodialysis (intermittent)]]
**[[CRRT -- incl for volume removal via PRISMA device]]
* ICD10: [[Renal dialysis care, including dialysis itself]]; this can't be used because it doesn't imply that it happened while there; if hemodialysys is done while admitted the CCI code should be used.
 
== Reality check ==
{{Discuss | who = Allan | question = 
* I could add restrictions to reduce false positives but maybe not trap odd cases. Can you think of a reasonable restriction? In [[Check CRF/ARF against TISS Dialysis]] we were saying "LOS > 3days; I could add some death concept to the restrictions if we can think of them. Actually, is there any reason the two checks would NOT use essentially the same combination of criteria for Tasks (med) vs TISS (icu)? It might even end up being the same check... if the dx + criteria are right, must have either task or TISS?Ttenbergen 15:54, 2017 April 27 (CDT)}}
 
== ICD10/CCI ==
* I don't know if any of this is actually implemented. At this point it should probably wait for CCI/ICD10.
 
 
See also [[Renal Coding Considerations for ICD10]].
 
== Short stay patients, incl community hospitals==
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.  


== Log ==
* 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 ==
{{Related Articles}}
{{Related Articles}}


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

Latest revision as of 08:51, 2024 April 24

Data Integrity Checks
Summary: If a profile has one of the #Dialysis CCI Items there should also be one of the #Dialysis qualifying Dxs.
Related: Peritoneal dialysis (TISS Item), CRRT (TISS Item), Intermittent hemodialysis (TISS Item), Kidney, acute renal failure NOS, Kidney, acute renal failure, postprocedural, Kidney, acute tubular necrosis (ATN), Kidney, renal failure/insufficiency/uremia, unspecified as acute or chronic, 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
Firmness: hard check
Timing: complete
App: CCMDB.accdb
Coding: query check_CCI_ICD10_Dialysis_no_Dx
Uses L Problem table: not relevant for this app
Status: implemented
Implementation Date: 2021-10-27
Backlogged: true
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If a profile has one of the #Dialysis CCI Items there should also be one of the #Dialysis qualifying Dxs.

Dialysis CCI Items

Dialysis qualifying Dxs

Allan confirmed that we would not need to add covid because if used in that context, renal failure would also be coded.

Log

Related articles

Related articles:
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