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Renal Coding Considerations (old): Difference between revisions

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These checks are currently done partly by Pagasa ([[! Automated Data Integrity Checks]]) and are about to be implemented in [[CCMDB.mdb]].
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|explanation=These are so different in ICD10 that we made a new page: [[ICD10 Guideline for Renal Coding]]
|successor=[[ICD10 Guideline for Renal Coding]]
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== Data Integrity Rules ==
See also [[ICD10 Guideline for Renal Coding]]
If comorbid [[CRF - Chronic Renal Failure|CRF]] (351-00) exists then the following must not appear in Admit/Acquired codes
* [[ARI]] (364-00)
* [[Acute Tubular Necrosis | ATN]]  (352-00)
* [[ARF (Diagnosis)]]  (350 **) must '''not''' be coded as Admit/Acquired '''except''' if Renal Transplant (805 00) is also coded as a comorbid


These rules are currently checked at the main office and result in calls for clarification from Pagasa if broken.
There are a few restrictions about which renal diagnoses can be coded together. These checks are currently done partly by Pagasa and have been partly implemented in [[CCMDB.accdb]].


== CRF in pt with transplant failure ==
Just a comment about '''[[CRF - Chronic Renal Failure]]''': when pt has [[Renal Transplant Problems]] and/or [[Renal Transplant|Renal Transplant - Removal of Transplant-Organ]] and requires dialysis, they can have acquired diagnoses of '''[[ARF (Diagnosis)]]''', '''[[Acute Tubular Necrosis (ATN)]]''' and/or [[ARI]], which is related to their new donor kidney.


* If comorbid [[CRF - Chronic Renal Failure]] exists, the ARF box in Apache Lab must not be checked.
== [[:Category:Renal insufficiency (old)]] ==
About to implement that. [[User:Ttenbergen|Ttenbergen]] 14:05, 27 August 2009 (CDT)
*'''Comorbid'''
**[[Renal insufficiency-mild (creatinine 160-240 mmol)]]
**[[Renal Insufficiency-moderate (Cr greater than 240)]]
*'''Admit or complication'''
**[[ARI]] there is a different range - creatinine rise of >250 mmol OR a rise of >100 mmol from baseline over 24 hrs. 
*'''No dialysis''' or
*'''N history of CRF''' 
**if patient required acute dialysis, it is not due to renal insufficiency - please see [[ARF]]
**This is in the code book but not on the Wiki.  (code books OLD so folks should not use).


== Data Integrity Checks ==
These rules are currently checked at the main office and result in calls for clarification from Pagasa if broken. Some of them have been added to [[CCMDB.accdb]], more are to follow.


===discussion===
=== CCMDB Data Integrity Checks: Competing Diagnoses ===
{{discussion}}
see [[query Check Renal IncompatibleDxs]]
When these are addressed, please edit [[Requested CCMDB changes for the next version#ARF & CRF & ARI Integrity Check | Requested CCMDB changes for the next version]] to state the discussion is done so the checks can be implemented in [[CCMDB.mdb]].


* I think we decided to get rid of the renal transplant part for this, right? If so, please remove both that part and this comment... Otherwise, the one-week clock is now ticking for its removal, pending an explanation why it should not be removed. [[User:Ttenbergen|Ttenbergen]] 10:57, 23 April 2009 (CDT)
=== Diagnoses, Comos vs. Tasks, locations ===
* see [[Check_Renal_Tasks]]


=== Apache vs. CRF comorbid ===
* see [[Query check ApARF CRF]].


* The 364 is new since the discussion about the cleaner. What is it about? [[User:Ttenbergen|Ttenbergen]] 15:55, 5 November 2008 (CST)
=== Apache vs. ARF Dx ===
**Yes, since I have been further reviewing patient profiles in more detail from the problems that SAS has generated, I see renal insufficiency (364) being coded in admit or complication DX slots for patients who have a comorbid condition of chronic renal failure (351).
cross-checks impossible due to different definitions, see [[ARF (Diagnosis)]] and [[ARF (APACHE)]]
*This article mentions something about transplant. Is that still accurate? [[User:Ttenbergen|Ttenbergen]] 14:12, 18 February 2009 (CST)


== Data Integrity Checks that can '''not''' be checked before sending==
* ''Query check_CCI_TISS_Dxs_vs_Dialysis''


== Related articles ==
see [[:Category:Renal Problem (old)]] for other renal problems
{{Related Articles}}


 
[[Category:Renal Problem (old)]]
 
}}
[[Category: Questions]]
[[Category: Data Integrity Rules]]
[[Category: Questions Diagnosis]]
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