Query check CCI ICD10 Dialysis no Dx
| 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: | needs review |
| 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)
- Pt Monitored while on Dialysis (398)
- 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
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
Has a Dialysis CCI but no #Dialysis TISS Items for ICU 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 #Dialysis TISS Items
Has #Dialysis TISS Items but no Dialysis CCI for ICU 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 of #Dialysis TISS Items
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
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
Reality check
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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.