Renal Transplant

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This page is about the pre-ICD10 diagnosis coding schema. See the ICD10 Diagnosis List, or the following for similar diagnoses in ICD10:

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Category/Organ System:	Category: Renal Transplant Surgery (old)
Type:
Main Diagnosis:	805-00
Sub Diagnosis:	Critical Care and Medicine
Diagnosis Code:	Currently Collected
Comorbid Diagnosis:
Charlson Comorbid coding (pre ICD10):
Program:
Status:

Considerations for entering Tasks

Note: Patients have underlying CRF and are on chronic HD or PD. Task is marked Chronic HD or Chronic PD only if they receive HD or PD in hospital prior to surgery. Rarely is HD given. Usually PD is given (instilled overnight and drained in morning)

If patient receives kidney transplant and develops complication of Hyper K+, renal failure, rejection etc. post-op and subsequently require dialysis this is Acute HD or Acute PD.

Future admissions of Renal Transplant Recipient

Renal Transplant Patients: On their next admission do not add CRF in the Comorbids because this will indicate that transplant rejected/or not successful.

Renal Transplant Recipient who is back in CRF

• If the patient is back in CRF due to rejection and receiving hemodialysis or peritoneal dialysis, enter Renal Transplant Rejection (361-01) as the last admit (When this is not an acute problem). Then enter Renal Transplant and CRF in co-morbs. Mark appropriate task as Chronic.

• If a renal transplant is not working but it is not clearly related to rejection, use Renal Transplant Problems - Other 361-90.

Discussion

• "enter Renal Transplant Rejection (361-01) as the last admit" - does it have to be an admit? What if it happens during the stay, would it not be an acquired instead? Ttenbergen 14:51, 29 July 2008 (CDT)
• what if the patient is not receiving dialysis, for whatever reason (e.g. DC Treat) - do you not code rejection anyway?Ttenbergen 14:51, 29 July 2008 (CDT)

Data Integrity Rules

See... CRF - Chronic Renal Failure

Discussion

• How is the donor coded for a living donor? The detail may not need to go into here if there is a specific code, but there should be a link from here. Ttenbergen 14:35, 29 July 2008 (CDT)

Topic moved from CRF vs ARF, ARI, Renal Transplant; this may already be addressed here, but it did not belong into the article where it was:

• So how do you check for patients with renal transplant in comorbid, done many years ago, but patient has been receiving outpatient dialysis for some time because of transplant failure prior to admission? TOstryzniuk 16:22, 8 October 2008 (CDT)
  • We just check the data as part of the checks done as requested by Julie. Your question seems to relate more to how the data collectors should be getting that data. You have identified an important question that should be addressed as part of the article Renal Transplant. Should we move this thread there instead? Ttenbergen 14:21, 18 February 2009 (CST)

Comment transferred from Talk Page

(we don't use the talk page, see here for more.) Does a renal transplant patient always admit from home?Ttenbergen 16:45, 25 April 2008 (CDT)

Example scenario renal transplant process for coding purposes

Renal Transplant Patient coding process

• Patient Type (Registry): Surgical
• Apache Type: Elective Surgery
• Admit DX: Pre-op Optimization - 893
• Complication is only one of:
  • Renal Transplant – living donor – 805-04
  • Renal Transplant – Cadaver donor 805-05

Renal Donor

• Admit: Recovery Room
• Patient Type (Registry): Surgical
• Apache Type: Elective Surgery
• Admit Dx: Nephrectomy – Kidney Donor 801-01 Nephrectomy

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