Query check CCI ICD10 Dialysis no Dx: Difference between revisions

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If there is a [[TISS28]] entry for Hemodialysis there should be a corresponding Dx.
If there is a [[TISS28]] entry for Hemodialysis there should be a corresponding Dx.
=== Dialysis TISS Items ===
*[[Intermittent hemodialysis (TISS Item)]] (T32)
*[[Intermittent hemodialysis (TISS Item)]] (T32)
*[[CRRT (TISS Item)]] (T33)
*[[CRRT (TISS Item)]] (T33)
*[[Peritoneal dialysis (TISS Item)]] (T34)
*[[Peritoneal dialysis (TISS Item)]] (T34)


== CRF/ARF vs [[TISS28]] items 32, 33, 34 ==
=== Dialysis requiring Dxs ===
=== Has ARF/CRF but not Dialysis ===
*[[ARF (Diagnosis)]](350)
*[[Pt Monitored while on Dialysis]] (398)
 
=== Dialysis qualifying Dxs ===
all [[#Dialysis requiring Dxs]] plus:
*[[CRF - Chronic Renal Failure]](351) (not mandatory because what if they die/discharge before dialysis?)
 
== Checks ==
=== Has [[#Dialysis requiring Dxs]] but no [[#Dialysis TISS Items]] ===
If meets following the entry is an error:  
If meets following the entry is an error:  
* ICU patient  
* ICU patient  
* LOS>3  
* LOS>3  
* at least one of dxs ([[ARF (Diagnosis)]](350), [[CRF - Chronic Renal Failure]](351)
* at least one [[#Dialysis requiring Dxs]]
* '''doesn't have''' one of (T32/33/34) in TISS28
* '''doesn't have''' any [[#Dialysis TISS Items]]


=== TISS implies dx ===
=== Has [#Dialysis TISS Items]] but no [[#Dialysis qualifying Dxs]] ===
If meets following the entry is an error:  
If meets following the entry is an error:  
* ICU patient  
* ICU patient  
* LOS>3  
* LOS>3  
* at least one of (T32/33/34) in TISS28
* at least one of [[#Dialysis TISS Items]]
* '''doesn't have''' one of dxs ([[ARF (Diagnosis)]](350), [[CRF - Chronic Renal Failure]](351), [[Pt Monitored while on Dialysis]] (398),
* '''doesn't have''' one [[#Dialysis qualifying Dxs]]


== Reality check ==
== Reality check ==
{{discussion}}
{{discussion}}
* Collectors can you see a scenario where this would not be an error? If not, this could be added to [[Change Priorities]]. Ttenbergen 20:17, 2014 April 30 (CDT){{Potential Change}}
 
**codes 350 through 355 all pertain to ARF, however the other remaining codes are not correct, as they do not necessarily mean that dialysis is started [[User:Lkaita|Lisa Kaita]] 12:03, 2017 April 25 (CDT) 
*** So there are codes that ''might'' have dialysis, and codes that ''would'' have dialysis, right? I updated the two listings above. If pt has a dialysis-mandatory dx, must have TISS. If a pt has TISS, must have a dialysis-optional dx. Does the list of dxs in each case look right now? And, can you think of scenarios where these errors would lead to false positives? Ttenbergen 17:12, 2017 April 26 (CDT)
****Sorry T I misread the diagnostic codes, was looking at subcodes of 350, so I updated the above.  350 ARF always has dialysis, 351 CRF comorbid (chronic dialysis)could potentially create a false positive if a patient is admitted and dies before every receiving dialysis, this does not happen very often, but the potential is there.  All other codes "might" have dialysis but would usually be coded in addition to 350 if they are being dialyzed.[[User:Lkaita|Lisa Kaita]] 10:11, 2017 April 27 (CDT)
***** 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)
***** 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)
* I don't know if any of this is actually implemented. At this point it should probably wait for CCI/ICD10.  
* I don't know if any of this is actually implemented. At this point it should probably wait for CCI/ICD10.  

Revision as of 17:23, 2018 September 17

If there is a TISS28 entry for Hemodialysis there should be a corresponding Dx.

Dialysis TISS Items

Dialysis requiring Dxs

Dialysis qualifying Dxs

all #Dialysis requiring Dxs plus:

Checks

Has #Dialysis requiring Dxs but no #Dialysis TISS Items

If meets following the entry is an error:

Has [#Dialysis TISS Items]] but no #Dialysis qualifying Dxs

If meets following the entry is an error:

Reality check

Template:Discussion

          • 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)
  • I don't know if any of this is actually implemented. At this point it should probably wait for CCI/ICD10.

Template:ICD10Template:CCI 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.

Template:Data Integrity Checks

Not yet implemented.

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