Guideline for coding organ donation after death: Difference between revisions

← Older edit Newer edit →

@@ Line 4: / Line 4: @@
 == Instructions for coding these patients ==
-{{DA | If I understand all this right we will not actually be coding [[Organ donor (organ/tissue donation by the donor)]] for these, since that will always happen elsewhere, and pt won't come back to us after, so not our dx. If I understand that right we should probably put a one-liner here to make that clear since it's a bit counter-intuitive. And likely at that page as well. }}
+{{DA |
+* If I understand all this right we will not actually be coding [[Organ donor (organ/tissue donation by the donor)]] for these, since that will always happen elsewhere, and pt won't come back to us after, so not our dx. If I understand that right we should probably put a one-liner here to make that clear since it's a bit counter-intuitive. And likely at that page as well.
+* What date in the [[Acquired Diagnosis]] do you put for this code?   Do you use the date that they decide the pt will be an organ donor?  Or would you prefer the date the patient goes to the OR (which would be the same as the discharge date?
+** These patients go to a different ward after transplant, right? So we would likely not currently track the CCI for this. Maybe transplants are something we should track if they are at the end of stay. I'll flag this for Allan.
+***I am referring to an organ donor (not a transplant recipient). Most donors go to the morgue after donating their organs in the OR.  I am not asking about CCI, just the date for the acquire ICD10 code.  I am not sure who wrote the above comment.}}
 * [[Dispo DtTm]]: '''sent from ICU to the operating room or to another ICU''' (consistent with other [[Operating room visits]]
@@ Line 25: / Line 29: @@
 * [[Admit Diagnosis]]: [[Brain death]]
 * [[Previous Location]]: the previous ICU
-* [[Dispo]]: Hopefully "Death - to morgue", or "Death - to morgue" if transplant doesn't work out
+* [[Dispo]]: Hopefully "Death - to OR", or "Death - to morgue" if transplant doesn't work out
 * [[Dispo DtTm]]:
-{{DA |
+=== Donation after Cardiac Death (DCD) ===
-* What date in the [[Acquired Diagnosis]] do you put for this code?   Do you use the date that they decide the pt will be an organ donor?  Or would you prefer the date the patient goes to the OR (which would be the same as the discharge date?
+Donation after cardiac death (DCD) is where a donor who is not brain dead is dependent on life support and the family has decided to withdraw care. When the patient's heart stops beating, the organs are then recovered in the operating room.
-** These patients go to a different ward after transplant, right? So we would likely not currently track the CCI for this. Maybe transplants are something we should track if they are at the end of stay. I'll flag this for Allan.
-***I am referring to an organ donor (not a transplant recipient). Most donors go to the morgue after donating their organs in the OR.  I am not asking about CCI, just the date for the acquire ICD10 code.  I am not sure who wrote the above comment.}}
-We will not have a separate code for cadaver donations. Instead also code the following as appropriate
+These would be coded with [[Dispo]] as the OR where they are going. They are not dead when they leave, so they are '''not''' "Death - to OR".
-*After brain death:  '''[[Brain death]]'''
-*Donation after Medical Assistance in Dying ([[MAID]]) -- where a person who undergoes MAID has made arrangements in advance for organ harvesting after death.
-We do not have a special code for:
-*Donation after cardiac death (DCD) -- where a donor who is not brain dead is dependent on life support and the family has decided to withdraw care. When the patient's heart stops beating, the organs are then recovered in the operating room.
-Some organ donors have a '''bronchscopy''' done, but not all do, so don't automatically assume and code it. The only time it is done is if there are considering the lungs.  This is according to a Respirologist from STB ICU.
+=== MAID ===
+Medical Assistance in Dying ([[MAID]]) is where a person who undergoes MAID has made arrangements in advance for organ harvesting after death.
-=== Donation after Cardiac Death (DCD) ===
+{{DA | What are the instructions for this? Would they go through the exercise of declaring such a patient's [[Brain death]] or would we capture them as [[Acquired Diagnosis]] [[MAID]] and [[Dispo]] "Death - to OR"?  }}
-*For a braindead donor, or a DCD (donation after cardiac death = almost dead in ICU but decision made to donate by taking patient or OR, removing life support until dead, then harvest organs) it almost always will be an acquired diagnosis.  For those the date of that acquired diagnosis should be.... we still need to decide, see: [[Deceased patients]].
 == How they are treated in linking ==