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| {{DX tag | Renal | Medical Problem | Acute Renal Insufficiency | | [[36400 - ARI-Acute Renal Insufficiency]]| No | 0 - 2 |'''Critical Care and Medicine''' | Currently Collected | | |}} | | {{PreICD10 dx | NewDxArticle = Kidney, acute renal failure NOS }} |
| '''A'''cute '''R'''enal '''I'''insufficiency
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| =={{G|Guideline}}==
| | {{DX tag | Renal | Medical Problem | Acute Renal Insufficiency | | 36400 | No | 0 - 2 |'''Critical Care and Medicine''' | Currently Collected | | |}} |
| *''' Creatinine >250 mmol or a Rise >100 mmol from baseline over 24 hours''' | | |
| | see |
| | *[[Renal Insufficiency-moderate (Cr greater than 240)]] |
| | *[[Renal insufficiency-mild (creatinine 160-240 mmol)]] for the related comorbid codes |
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| | '''A'''cute '''R'''enal '''I'''nsufficiency |
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| | ==Guideline== |
| | *'''A Rise >100 mmol from baseline over 24 hours''' |
| * a patient is '''not''' on chronic hemodialysis or peritoneal dialysis | | * a patient is '''not''' on chronic hemodialysis or peritoneal dialysis |
| * I don't think that just having a creatinine of >250 should automatically mean ARI. This could be the patient's baseline and therefore is a chronic issue. My opinion is to only use the rule of >100 mmol over baseline over 24 hours for '''acute''' renal insufficiency (without dialysis), or use ATN if this is documented. --[[User:LKolesar|LKolesar]] 07:13, 2014 October 8 (CDT) | | * If the prior Creatinine level is unknown use > 250 as a guideline to code ARI. |
| ** Are we to change what we have being doing for over 10 years ?--[[User:PStein|PStein]] 09:54, 2014 October 15 (CDT)
| | * check what the pts baseline ''' per doctors note''' creatinine was prior to admission. If creatinine was > or equal to 250 last admission code as ARI if the present creatinine was 350 or more. |
| ** I am just putting my opinion here, if any changes are done they will have to go through the task group first.--[[User:LKolesar|LKolesar]] 11:28, 2014 October 15 (CDT)
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| == {{Data Integrity Checks}} ==
| | {{Data Integrity Check List}} |
| There are a number of coding rules related to renal diagnoses, centralized info about them is in [[Renal Coding Considerations]].
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| ** I always check what the pts baseline creatinine was prior to admission if the pt had chronic renal insuffiency and creatinine was 250 last admission I will code as mod CRI if the present creatinine was say 350 I will code acute RI in admits and CRI in comorbids If the creat was the same as last admission say 250 and pt has CRI I only code in comorbids because it is not acute. | | == Related articles == |
| | {{Related Articles}} |
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| [[Category: Diagnosis Coding]]
| | [[Category:Renal Problem (old)]] |
| [[Category: Charlson - Renal]]
| | [[Category:Renal insufficiency (old)]] |
| [[Category: Renal Problem]] | |
| [[Category: Renal insufficiency]] | |