Renal Coding Considerations (old)
These checks are currently done partly by Pagasa (! Automated Data Integrity Checks) and are about to be implemented in CCMDB.mdb.
Data Integrity Rules that can be checked before sending
These rules are currently checked at the main office and result in calls for clarification from Pagasa if broken. Some of them have been added to CCMDB.mdb, more are to follow.
Competing Diagnoses
If comorbid CRF (351-00) exists then the following must not appear in Admit/Acquired codes
- ARI (364-00)
- ATN (352-00)
- ARF (Diagnosis) (350 **)
Diagnoses, Comos vs. Tasks
Dialysis task is required if all of the following are true:
- one of the following is present:
- LOS >= 3
- Renal Transplant (80504 or 80505) is not present
Apache vs. CRF comorbid
- If comorbid CRF - Chronic Renal Failure exists, the ARF box in Apache Lab must not be checked.
Apache vs. ARF Dx
cross-checks impossible due to different definitions, see ARF (Diagnosis) and ARF (APACHE)
Data Integrity Rules that can not be checked before sending
ARF and ICU TISS
- TISS 53 to 55: Don't forget to cross check the TISS form with the diagnosis and visa versa.
ARF & TISS integrity checks
- have TISS 53, 54, 55 but no Renal failure DX (350, 351, 352, 355, 356, 398, 450-499, 327, 357)
- from community hosp to teaching hosp with DX of 350 AND no dialysis on TISS at community hosp AND DX of 350 AND TISS 53, 54 or 55 marked at teaching hospital, then the DX of ARF for community hospital is correct.