Check Renal Tasks

dx implies task

If a medicine patient has LOS >= 3

• HD or PD task is required if all of the following are true:
  • one of the following is present:
    • comorbid CRF
    • diagnosis ARF
  • Renal Transplant (80504 or 80505) is not present

which dxs?

• 350 ARF (Diagnosis)

• 351 CRF - Chronic Renal Failure as comorbid

task implies dx

If a medicine patient has LOS >= 3 and has a HD or PD task then must have one of the following dxs:

• comorbid CRF
• diagnosis ARF
• diagnosis ARI

which dxs?

• 350 ARF (Diagnosis)
• 352 ATN
• 356 Hepatorenal Syndrome
• 351 CRF - Chronic Renal Failure
• 364 ARI
• (other?)

Questions prior to implementing

excluding community hospitals

Apparently neither HD nor PD is done at community hospitals.

• Dialysis Task must never be marked for
  • GRA N3/N5/W3
  • VIC N5/S3/S4/S5

• Since we only check patients with LOS>3, do we need to consider this? If a pt with CRF/ARF is in hospital longer than 3 days would dialysis not need to be accommodated? IE, would the patient then not need to be sent to a different hospital that can dialyze? Ttenbergen 21:02, 2014 April 30 (CDT)
• from ! Automated Data Integrity Checks:
  • there are exceptions: If Grace and VIC Med send patient for dialysis to HSC or STB, then they return back to medicine bed, TASK will be marked with dialysis for their site. (As per Trish, I think)
    • Except those, community sites should not have dialysis task, right? Ttenbergen 17:14, 27 October 2008 (CDT)
  • So these locations would not admit patients who are, say, on home peritoneal dialysis?
    • DC never encounter such case

palliation?

• Could any of (e) or (f) be OK if the patient is palliative? (Tina)
  • Yes. Found cases of palliative with dialysis. (Julie)
    • Yes, but could a palliative patient not also arrive and not get dialysis even if they are CRF? (Tina)(all from old discussion during ! Automated Data Integrity Checks)

Do we need to exclude palliative pts in this check? If so, based on what? Ttenbergen 21:02, 2014 April 30 (CDT) Template:Discussion

Renal Transplant not present

If 351 in comorbid Dx AND Admit DX 1 = 893 (pre op admission) AND complication = 805-4 or 805-5 then TASK DIALYSIS should not be marked.-PTorres 16:06, 21 October 2008 (CDT). Not sure if Julie applies this detail or not.Trish Ostryzniuk 11:45, 2014 February 4 (CST)

• No dialysis prior to transplant while waiting in hospital? No dialysis after transplant if things go wrong? That restriction could lead to errors being listed. Ttenbergen 12:37, 2014 May 5 (CDT)

Implementation

Hardcoded in query Check_Renal_Tasks in CCMDB.mdb. This will need to be changed!

Start Date

TBA, once discussion above is resolved

Status

being implemented once discussion is resolved

Related Articles

• Renal Coding Considerations
• Dialysis Tasks