Past history, transplanted kidney: Difference between revisions

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== Additional Info ==

~~===How to use this in regard to patient moving through their hospital admission===~~

*These notes are to resolve possible ambiguity for the situation where the patient received the transplant during the current hospitalization.

*Of course if the transplant occurred during a prior hospitalization, then this code can be used.

*But what about if the transplant was done during the current hospitalization, and they move from place to place within the hospital?

**If the person was admitted to the service directly after the transplant surgery, this code isn't used. For example, patient came in for elective transplant, had it, and came directly to SICU. In that case the SICU database record would have ESRD as an admitting diagnosis, and the transplant would be indicated by a CCI procedure code for it. So the SICU database record would not list [[Past history, transplanted kidney]].

**Continuing that example, after SICU the person routinely went to the ward for further routine postop convalesence, then again ESRD is an admitting diagnosis, and the transplant would be indicated by a CCI procedure code for it. So again this ward database record would not list [[Past history, transplanted kidney]].

**But, if the person was in SICU post-transplant, then went to a surgery ward where they developed new problem such as DKA, and was then transferred to your Medicine ward, in '''that''' case it would be appropriate to code '''[[Past history, transplanted kidney]]'''.

***So in brief, if a person had the kidney transplant during the current hospitalization, you'd only code '''[[Past history, transplanted kidney]]''' in the current database record if the reason for being admitted to your unit (ward or ICU) was a different problem, i.e. not the kidney transplant.

== Alternate ICD10s to consider coding instead or in addition ==

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*[[Kidney, acute tubular necrosis (ATN)]]

*[[Prerenal uremia/state]]

*[[Chronic kidney disease (~~uremia,~~ chronic renal insufficiency) Stage 1]]

*[[Chronic kidney disease (chronic renal insufficiency, uremia) Stage 1, GFR GT 90]]

*[[Chronic kidney disease (~~uremia,~~ chronic renal insufficiency) Stage 2]]

*[[Chronic kidney disease (chronic renal insufficiency, uremia) Stage 2, GFR 60-89]]

*[[Chronic kidney disease (~~uremia,~~ chronic renal insufficiency) Stage 3]]

*[[Chronic kidney disease (chronic renal insufficiency, uremia) Stage 3, GFR 30-59]]

*[[Chronic kidney disease (~~uremia,~~ chronic renal insufficiency) Stage 4]]

*[[Chronic kidney disease (chronic renal insufficiency, uremia) Stage 4, GFR 15-29]]

== Related CCI Codes ==

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* [[(T) Kidney]]

* [[Transplant]]

== Related Articles ==

@@ Line 12: / Line 12: @@
 == Additional Info ==
-===How to use this in regard to patient moving through their hospital admission===
+{{Kidney Transplant Coding Guidelines}}
-*These notes are to resolve possible ambiguity for the situation where the patient received the transplant during the current hospitalization.
-*Of course if the transplant occurred during a prior hospitalization, then this code can be used.
-*But what about if the transplant was done during the current hospitalization, and they move from place to place within the hospital?
-**If the person was admitted to the service directly after the transplant surgery, this code isn't used.  For example, patient came in for elective transplant, had it, and came directly to SICU.  In that case the SICU database record would have ESRD as an admitting diagnosis, and the transplant would be indicated by a CCI procedure code for it.  So the SICU database record would not list [[Past history, transplanted kidney]].
-**Continuing that example, after SICU the person routinely went to the ward for further routine postop convalesence, then again ESRD is an admitting diagnosis, and the transplant would be indicated by a CCI procedure code for it.  So again this ward database record would not list [[Past history, transplanted kidney]].
-**But, if the person was in SICU post-transplant, then went to a surgery ward where they developed new problem such as DKA, and was then transferred to your Medicine ward, in '''that''' case it would be appropriate to code '''[[Past history, transplanted kidney]]'''.
-***So in brief, if a person had the kidney transplant during the current hospitalization, you'd only code '''[[Past history, transplanted kidney]]''' in the current database record if the reason for being admitted to your unit (ward or ICU) was a different problem, i.e. not the kidney transplant.
-{{ICD10 Guideline Kidney transplant vs ESRD}}
+{{ICD10 Guideline Past medical history}}
 == Alternate ICD10s to consider coding instead or in addition ==
@@ Line 33: / Line 26: @@
 *[[Kidney, acute tubular necrosis (ATN)]]
 *[[Prerenal uremia/state]]
-*[[Chronic kidney disease (uremia, chronic renal insufficiency) Stage 1]]
+*[[Chronic kidney disease (chronic renal insufficiency, uremia) Stage 1, GFR GT 90]]
-*[[Chronic kidney disease (uremia, chronic renal insufficiency) Stage 2]]
+*[[Chronic kidney disease (chronic renal insufficiency, uremia) Stage 2, GFR 60-89]]
-*[[Chronic kidney disease (uremia, chronic renal insufficiency) Stage 3]]
+*[[Chronic kidney disease (chronic renal insufficiency, uremia) Stage 3, GFR 30-59]]
-*[[Chronic kidney disease (uremia, chronic renal insufficiency) Stage 4]]
+*[[Chronic kidney disease (chronic renal insufficiency, uremia) Stage 4, GFR 15-29]]
 == Related CCI Codes ==
@@ Line 42: / Line 35: @@
 * [[(T) Kidney]]
 * [[Transplant]]
+{{Data Integrity Check List}}
 == Related Articles ==