Query check CCI ICD10 Dialysis no Dx: Difference between revisions
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=== Dialysis requiring Dxs === | === Dialysis requiring Dxs === | ||
*[[ARF (Diagnosis)]](350) | *[[ARF (Diagnosis)]](350) ------------- Tina this is old and needs to be removed from here | ||
*[[Pt Monitored while on Dialysis]] (398) | *[[Pt Monitored while on Dialysis]] (398) -------------- Ditto | ||
[[Concept:Acute renal failure]]: | [[Concept:Acute renal failure]]: | ||
{{#ask: [[Concept:Acute renal failure]] | {{#ask: [[Concept:Acute renal failure]] | ||
Line 33: | Line 33: | ||
|limit=10}} | |limit=10}} | ||
*[[Hyperkalemia]] | *[[Hyperkalemia]] | ||
*[[Congestive heart failure with pulmonary edema]] | |||
*[[Fluid overload]] | *[[Fluid overload]] | ||
*[[ | *Metabolic acidosis: [[Acidosis, NOS]] or [[Kidney, renal tubular acidosis (RTA, all types)]] | ||
*Drug overdoses and poisonings | *Drug overdoses and poisonings -- the main ones are: | ||
**[[ | ** Aspirin & other salicylates -- [[Aspirin other salicylate or NSAID, overdose/toxicity]] | ||
**[[ | ** Valproic acid, carbemazepine (Tegretol), phenytoin (Dilantin), barbiturates -- [[Antiseizure drug NOS, overdose/toxicity]] | ||
**[[ | ** Metformin -- [[Insulin or other antidiabetes drug, overdose/toxicity]] | ||
** Lithium -- [[Psychiatric drug NOS, overdose/toxicity]] | |||
** Theophylline -- [[Drug or biological substance/agent NOS, overdose/toxicity]] | |||
** Alcohols -- [[Alcohol (ethanol), poisoning]] or [[Toxic alcohols, poisoning]] | |||
** Diltiazem -- [[Calcium channel blocker, overdose/toxicity]] | |||
** Occasionally a few others (rare) | |||
== Checks == | == Checks == |
Revision as of 14:18, 2018 November 27
Data Integrity Checks | |
Summary: | If there is a TISS28 entry for Hemodialysis there should be a corresponding Dx. |
Related: | Intermittent hemodialysis (TISS Item), Peritoneal dialysis (TISS Item), CRRT (TISS Item), ARF (Diagnosis), Pt Monitored while on Dialysis |
Firmness: | hard check |
Timing: | complete |
App: | Centralized data front end.accdb |
Coding: | not entered |
Uses L Problem table: | No |
Status: | ready to implement |
Implementation Date: | not entered |
Backlogged: | true |
If there is a TISS28 entry for Hemodialysis there should be a corresponding Dx.
Dialysis TISS Items
- Intermittent hemodialysis (TISS Item) (T32)
- CRRT (TISS Item) (T33)
- Peritoneal dialysis (TISS Item) (T34)
Dialysis requiring Dxs
- ARF (Diagnosis)(350) ------------- Tina this is old and needs to be removed from here
- Pt Monitored while on Dialysis (398) -------------- Ditto
- Kidney, acute renal failure NOS
- Kidney, acute renal failure, postprocedural
- Kidney, acute tubular necrosis (ATN)
- Kidney, renal failure/insufficiency/uremia, unspecified as acute or chronic
Dialysis qualifying Dxs
all #Dialysis requiring Dxs plus:
- CRF - Chronic Renal Failure(351) (not mandatory because what if they die/discharge before dialysis?)
Concept:Chronic Kidney Disease:
- Chronic kidney disease (chronic renal insufficiency, uremia) Stage 1, GFR GT 90
- Chronic kidney disease (chronic renal insufficiency, uremia) Stage 2, GFR 60-89
- Chronic kidney disease (chronic renal insufficiency, uremia) Stage 3, GFR 30-59
- Chronic kidney disease (chronic renal insufficiency, uremia) Stage 4, GFR 15-29
- Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15
- Chronic kidney/renal disease, NOS (stage unspecified)
- Kidney, renal failure/insufficiency/uremia, unspecified as acute or chronic
- Hyperkalemia
- Congestive heart failure with pulmonary edema
- Fluid overload
- Metabolic acidosis: Acidosis, NOS or Kidney, renal tubular acidosis (RTA, all types)
- Drug overdoses and poisonings -- the main ones are:
- Aspirin & other salicylates -- Aspirin other salicylate or NSAID, overdose/toxicity
- Valproic acid, carbemazepine (Tegretol), phenytoin (Dilantin), barbiturates -- Antiseizure drug NOS, overdose/toxicity
- Metformin -- Insulin or other antidiabetes drug, overdose/toxicity
- Lithium -- Psychiatric drug NOS, overdose/toxicity
- Theophylline -- Drug or biological substance/agent NOS, overdose/toxicity
- Alcohols -- Alcohol (ethanol), poisoning or Toxic alcohols, poisoning
- Diltiazem -- Calcium channel blocker, overdose/toxicity
- Occasionally a few others (rare)
Checks
Has #Dialysis requiring Dxs but no #Dialysis TISS Items
If meets following the entry is an error:
- ICU patient
- LOS>3
- at least one #Dialysis requiring Dxs
- doesn't have any #Dialysis TISS Items
Has #Dialysis TISS Items but no #Dialysis qualifying Dxs
If meets following the entry is an error:
- ICU patient
- LOS>3
- at least one of #Dialysis TISS Items
- doesn't have one #Dialysis qualifying Dxs
Not checks
Has a Dialysis CCI but no #Dialysis TISS Items for ICU only
Has #Dialysis TISS Items but no Dialysis CCI for ICU only
Has a Dialysis CCI but no TASKS for Medicine only
- CCI:
- ICD10: Renal dialysis care, including dialysis itself; this can't be used because it doesn't imply that it happened while there; if hemodialysys is done while admitted the CCI code should be used.
- doesn't have any TASKS item
- Tasks will go away in ICD10/CCI, so check not needed. Ttenbergen 22:34, 2018 November 18 (CST)
Has TASKS item but no Dialysis CCI for Medicine only
- doesn't have any CCI:
- ICD10: Renal dialysis care, including dialysis itself; this can't be used because it doesn't imply that it happened while there; if hemodialysys is done while admitted the CCI code should be used.
- at least one TASKS item
- Tasks will go away in ICD10/CCI, so check not needed. Ttenbergen 22:34, 2018 November 18 (CST)
Reality check
|
ICD10/CCI
- I don't know if any of this is actually implemented. At this point it should probably wait for CCI/ICD10.
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.