Kidney Transplant Coding Guidelines: Difference between revisions

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=== Patient waiting for donation ===

=== Patient receiving donation during this admssion ===

=== Past transplant recipient ===

[[Past history, transplanted kidney]]

*[[Kidney transplant, failure or rejection or unspecified complication]] covers several situations related to a [[Past history, transplanted kidney]]:

**Ongoing acute or chronic rejection

**The transplant has failed

**Other complications that relate to the transplanted kidney itself.

*If you use this code, you should not also code '''[[Past history, transplanted kidney]]''', because that is implicit in this code.

== Michelle's content ==

The Primary ICD 10 diagnoses for a patient admitted preoperatively for a kidney transplant is:

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~~'''~~Special coding considerations~~'''~~

ICD10 Guideline Transplant

===Special coding considerations===

*Almost (if not all) patients will have a comorb diagnosis of [[Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15]]. Rarely, a patient will have a transplant prior to ever being dialyzed. These patients would still be considered Stage 5, unless their GFR is greater than 15, in which case, use the chronic kidney disease code that corresponds to their GFR.

*Most transplant patients are coming from home, so Previous Location will be "home", and Previous Service will be "not applicable".

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*'''Don't''' code: [[Immunodeficiency state, NOS]], and [[Surgical follow-up care]] for these patients post-op, because these are assumed/routine for all transplant patients.

===CCI coding===

~~'''~~CCI coding~~'''~~

*Often, admitted patients will receive a peritoneal or hemodialysis treatment prior to surgery. In this case, code this as an acquired CCI. If the patient requires a hemodialysis treatment post transplant as well, this will not be captured in the CCI, as we only code the first dialysis treatment during the hospitalization.

*To code the actual transplant (usually will be as an acquired, unless they are coming to your ward post-op), use "Kidney (T)", combined with "Transplant". As part of the procedure, patients will also have a ureteral stent placed. This is routine, and does not need to be coded as a CCI. If a biopsy of the kidney is done during the procedure, code this as "kidney (D)", combined with "Biopsy (non-endoscopic)". If a biopsy is done, it will usually be indicated in the OR's print out summary.

===CMV+ or EBV+ prophylactic treatments===

~~'''~~CMV+ or EBV+ prophylactic treatments~~'''~~

When a donor is found to be CMV+ or EBV+, the recipient will often prophylactically be put on antiviral medication. This does not mean the recipient is, or should be coded as CMV+ or EBV+. Code only based on recipient positive tests.

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+{{ICD10 Guideline Transplant Failure}}
+{{ICD10 Guideline Kidney transplant vs ESRD}}
+=== Patient waiting for donation ===
+=== Patient receiving donation during this admssion ===
+=== Past transplant recipient ===
+[[Past history, transplanted kidney]]
+*[[Kidney transplant, failure or rejection or unspecified complication]] covers several situations related to a [[Past history, transplanted kidney]]:
+**Ongoing acute or chronic rejection
+**The transplant has failed
+**Other complications that relate to the transplanted kidney itself.
+*If you use this code, you should not also code '''[[Past history, transplanted kidney]]''', because that is implicit in this code.
+== Michelle's content ==
 The Primary ICD 10 diagnoses for a patient admitted preoperatively for a kidney transplant is:
@@ Line 6: / Line 24: @@
-'''Special coding considerations'''
+ICD10 Guideline Transplant
+===Special coding considerations===
 *Almost (if not all) patients will have a comorb diagnosis of [[Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15]]. Rarely, a patient will have a transplant prior to ever being dialyzed. These patients would still be considered Stage 5, unless their GFR is greater than 15, in which case, use the chronic kidney disease code that corresponds to their GFR.
 *Most transplant patients are coming from home, so Previous Location will be "home", and Previous Service will be "not applicable".
@@ Line 14: / Line 35: @@
 *'''Don't''' code: [[Immunodeficiency state, NOS]], and [[Surgical follow-up care]] for these patients post-op, because these are assumed/routine for all transplant patients.
+===CCI coding===
-'''CCI coding'''
 *Often, admitted patients will receive a peritoneal or hemodialysis treatment prior to surgery. In this case, code this as an acquired CCI. If the patient requires a hemodialysis treatment post transplant as well, this will not be captured in the CCI, as we only code the first dialysis treatment during the hospitalization.
 *To code the actual transplant (usually will be as an acquired, unless they are coming to your ward post-op), use "Kidney (T)", combined with "Transplant". As part of the procedure, patients will also have a ureteral stent placed. This is routine, and does not need to be coded as a CCI. If a biopsy of the kidney is done during the procedure, code this as "kidney (D)", combined with "Biopsy (non-endoscopic)". If a biopsy is done, it will usually be indicated in the OR's print out summary.
+===CMV+ or EBV+ prophylactic treatments===
-'''CMV+ or EBV+ prophylactic treatments'''
 When a donor is found to be CMV+ or EBV+, the recipient will often prophylactically be put on antiviral medication. This does not mean the recipient is, or should be coded as CMV+ or EBV+. Code only based on recipient positive tests.