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| (Tina says: this doesn't help. When qualified as "hospital encounter" or "hospital system encounter" it is all clear. I am concerned because "encounter" by itself could mean either unless apparent from the context. For a query I need to know which is meant, especially if the query then goes on to specify earlier and later encounters...) | | (Tina says: this doesn't help. When qualified as "hospital encounter" or "hospital system encounter" it is all clear. I am concerned because "encounter" by itself could mean either unless apparent from the context. For a query I need to know which is meant, especially if the query then goes on to specify earlier and later encounters...) |
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| THEREFORE (i.e. with reference to encounter definitions):
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| #if a patient is diagnosed with [[ARF]] (350) which means newly dialyzed and not on chronic outpatient dialysis '''prior to''' this admission (no 351 in comorbid) AND if during this encounter to hospital system, he continues to receive dialysis as he is moved around between hospitals and icu or medicine programs then he is still considered to be in [[ARF]].(Trish)
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| #* How would someone who didn't receive dialysis before '''continue''' to receive dialysis? [[User:Ttenbergen|Ttenbergen]] 14:53, 29 October 2008 (CDT)
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| #* Julie's directions had been: ''"If having more than 1 encounter (i.e.: continuous or same hospital admission), then [[ARF (Diagnosis)|ARF(350)]] and [[CRF - Chronic Renal Failure|CRF (351)]] should not appear together in at least one of the encounters."'' That's different from what Trish says now. Are we all on the same page? [[User:Ttenbergen|Ttenbergen]] 14:53, 29 October 2008 (CDT)
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| #* The definition that this patient would remain an ARF patient once they leave our ward, possibly are admitted somewhere where we don't collect, then maybe goes to the ICU, etc. is problematic since I don't think we can automatically assess that as the same hospital stay. More importantly, from what I hear about the quality of records travelling along with a patient, this is not something a DC at location 2 would be able to find out in any other way than by talking to the corresponding DC at location 1. This is an error prone, time consuming process, and I think we should re-consider the definition. [[User:Ttenbergen|Ttenbergen]] 14:53, 29 October 2008 (CDT)
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| #patients don't flip between (350)ARF and CRF (351) in the same encounter. (Trish)
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| #* so if someone enters hospital as ARF and stays here for 365 days on various wards with some icu stays, they should still be considered ARF during the last 3 day stay on a ward before they are discharged? I realize we don't flip back ''and forth'' but how about one way?[[User:Ttenbergen|Ttenbergen]] 14:53, 29 October 2008 (CDT)
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| #If the patient is discharged into the community, and will continue to receive outpatient dialysis, then the next time he is re admitted to a hospital in the city, he will be coded as CRF (351) in comorbid and admit or complication DX of ARF (350)cannot be used.(Trish)
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| #* as is true for anyone, so we can remove this point... [[User:Ttenbergen|Ttenbergen]] 14:53, 29 October 2008 (CDT)
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