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Renal Transplant: Difference between revisions

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{{DX tag | Renal | | Renal Transplant Surgery | |
{{DX tag | Renal | Surgical Problem | Renal Transplant Surgery | |
* 80500 - Renal Transplant Surgery
* 80500 - Renal Transplant Surgery
* 80501 - Removal of Transplant-Organ
* 80501 - Removal of Transplant-Organ
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This code (80503 - Rejection) is for the reason for surgery; see [[Renal Transplant Problems | 36101 - Renal Transplant Problems - Rejection ]] for the medical problem.  
This code (80503 - Rejection) is for the reason for surgery; see [[Renal Transplant Problems | 36101 - Renal Transplant Problems - Rejection ]] for the medical problem.  


=== Raw content from [[HSC Medicine Collection Guide]] ===
* Admit diagnosis:[[Pre OP admission-other]]
* Patient Type (Registry): Surgical
* Acquired diagnosis '''can not be both''':
* Admit diagnosis:Pre-Optimization-893
**Renal Transplant-living donor - 80504
* Complication is '''only one of''':
**Renal Transplant-Cadaver donor - 80505
**Renal Transplant-living donor-805-04
*See  [[Renal Coding Considerations (old)]]
**Renal Transplant-Cadaver donor-805-05
*See  [[Renal Coding Considerations]]
*usually patients are admitted from their home.If the recipient patient is not living in Winnipeg and is receiving a cadaveric donor kidney they may be instructed to go to their nearest hospital and arrangements will be made to transport them to HSC.
*usually patients are admitted from their home.If the recipient patient is not living in Winnipeg and is receiving a cadaveric donor kidney they may be instructed to go to their nearest hospital and arrangements will be made to transport them to HSC.
*The living donor recipients are scheduled by the renal clinic.The clinic will forward this information the week prior to surgery with the names of both the donor and recipient.
*The living donor recipients are scheduled by the renal clinic.The clinic will forward this information the week prior to surgery with the names of both the donor and recipient.
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*Once the patient has received a successful renal transplant and is discharged from the hospital,the next time they are admitted to hospital chronic renal failure will not be captured as a co-morbidity unless the transplanted kidney fails to function and dialysis is started again.
*Once the patient has received a successful renal transplant and is discharged from the hospital,the next time they are admitted to hospital chronic renal failure will not be captured as a co-morbidity unless the transplanted kidney fails to function and dialysis is started again.


*N.B Chronic renal failure patients who receive a transplant that is not successful,cannot have acute renal failure as an acquired diagnosis for our medical collection data program.This might be captured as delayed graft function/renal transplant problems other,or sometimes it is related to acute tubular necrosis and can be proven by renal biopsy. Other problems will be documented by the Nephrologists. Some problems are:
*If a renal transplant fails you might be able to code one of the following:  
**[[ARI]]  (364-00)  
**[[ARI]]  (364-00)  
**[[Acute Tubular Necrosis]]  (352-00)
**[[Acute Tubular Necrosis]]  (352-00)
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== Coding during the admission where transplant occurs ==
== Coding during the admission where transplant occurs ==
=== Renal Transplant Patient coding process ===
=== Renal Transplant Patient coding process ===
* [[Registry Patient Type]]: Surgical
* [[Admit Type for APACHE II]]: Elective Surgery
* [[Admit Type for APACHE II]]: Elective Surgery
* [[Previous Service]]: Not applicable if coming from home, Urology surgery if coming from the OR or PACU
* [[Previous Service]]: Not applicable if coming from home, Urology surgery if coming from the OR or PACU
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==== Discussion ====
==== Discussion ====
The following questions relate to improvements of the renal coding error checks. We need answers, and they need to stay on this page, if I am to put the internal consistency checks in place. Ttenbergen 14:46, 2013 January 31 (EST)
The following questions relate to improvements of the renal coding error checks. We need answers, and they need to stay on this page, if I am to put the internal consistency checks in place. Ttenbergen 14:46, 2013 January 31 (EST)
{{Discussion}}
++Discussion++
* Is the complication for organ source mandatory? Should there be a check for it? [[User:Ttenbergen|Ttenbergen]] 16:56, 3 September 2009 (CDT)
* Is the complication for organ source mandatory? Should there be a check for it? [[User:Ttenbergen|Ttenbergen]] 16:56, 3 September 2009 (CDT)
** as per Fran/Gail: "Yes and it gets coded under renal transplant surgery"
** as per Fran/Gail: "Yes and it gets coded under renal transplant surgery"
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moved to [[Dialysis_Tasks#Change_of_Dialysis_status_during_admission_-_Chronic_or_Acute.3F]] (delete this in a week)[[User:Ttenbergen|Ttenbergen]] 15:35, 14 September 2009 (CDT)
moved to [[Dialysis_Tasks#Change_of_Dialysis_status_during_admission_-_Chronic_or_Acute.3F]] (delete this in a week)[[User:Ttenbergen|Ttenbergen]] 15:35, 14 September 2009 (CDT)


== CMV+ or EBV+ diagnoses ==
== CMV+ or EBV+ prophylactic treatments ==
*Immune compromised renal transplants very occasionally become CMV+ or EBV+. This occurs when the donor is positive for CMV or EBV and the recipient was negative.The blood test is done by the Cadham Lab. The nephrologist will document this in the history or progress notes. The transplant recipient will be started on anti-viral medications approximately one week post-op and will continue these medications for six months and in conjunction their immune suppression drug dosage will be titrated lower.
When a donor is found to be CMV+ or EBV+ the recipient will often prophylactically be put on antiviral medication. '''This does not mean the recipient is, or should be coded as, CMV+ or EBV+. Code only based on positive tests.
* Diagnosis of this would be unlikely during the transplant hospital stay and you are not expected to follow the patient past discharge. Collect it if it's in the chart, e.g. on a subsequent admission. Julie links data behind the scenes. You would not keep the patient on your laptop after discharge. Hope that is what you meant, if not please clarify.Ttenbergen 17:12, 2013 August 15 (CDT)Thanks for this infor Tina. It clears up my question. (Judy)


== {{Data Integrity Checks}} ==
== Data Integrity Checks ==
There are a number of coding rules related to renal diagnoses, centralized info about them is in [[Renal Coding Considerations]].
There are a number of coding rules related to renal diagnoses, centralized info about them is in [[Renal Coding Considerations (old)]].
 
{{Data Integrity Check List}}


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




[[Category:Renal Problem]]
[[Category:Renal Problem (old)]]
[[Category:Diagnosis Coding]]
[[Category:Renal Surgery (old)]]
[[Category:Renal Surgery]]
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