Query check ICD10 ESRD vs AP ARF

Data Integrity Checks
Summary:	ARF (APACHE) and CRF - Chronic Renal Failure can not be coded together for the same patient.
Related:	ARF (APACHE), Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5
Firmness:	hard check
Timing:	always
App:	CCMDB.mdb
Coding:	query check_ICD10_ESRD_vs_AP_CRF
Uses L Problem table:	not relevant for this app
Status:	ready to implement
Implementation Date:	2018-11-24
Backlogged:	true

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"CCMDB.mdb" is not in the list (SAP, not entered, Centralized data front end.accdb, DSM Labs Consistency check.accdb, CCMDB.accdb, TISS28.accdb) of allowed values for the "DICApp" property. 

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ICD10

• If a person has pre-existing Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5 then they cannot subsequently have any of the various Acute Renal Failure/AKI diagnoses UNLESS they got a renal transplant in between --- so the ESRD is before the TP and the AKI is in the new/transplanted kidney.
  • So we will use the rule that no single database record can include both Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5 and an ARF/AKI code unless a kidney transplant occurred and the ARF/AKI is for the transplanted kidney.
• Thus, even though it is possible for an AKI to become fixed/permanent and become any level (1-5) of CRF -- this usually takes time (weeks to months) and for simplicity in coding, except for the case above where a renal TP occurred, the rule is that no single record should have both Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5 and an ARF/AKI code.
  • This really is only an issue for patients with very long hospital stays, and we've decided we can live with this small, uncommon inconsistency.

ARF (APACHE) should be always be NO when the person has comorbid Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5 or having Renal dialysis care, including dialysis itself in ICD10 diagnosis. --JMojica 12:28, 2018 November 13 (CST) A person with ARF could have dialysis, though, right, to treat the ARF? So, how about ARF (APACHE) checked and no (T) Kidney+Transplant / Past history, transplanted kidney / Kidney transplant, failure or rejection or unspecified complication means patient must not have Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5 Comorbid Diagnosis of Renal dialysis care, including dialysis itself Don't know if we can make that any tighter... OK --JMojica 16:48, 2018 November 19 (CST)-

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See Query check ApARF CRF for corresponding old dx check.

See also

• Renal Coding Considerations for ICD10