Organ Donor

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Revision as of 09:41, 2012 November 7 by Ttenbergen (talk | contribs) (discussion addressed, removing)
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Legacy Content

This page is about the pre-ICD10 diagnosis coding schema. See the ICD10 Diagnosis List, or the following for similar diagnoses in ICD10:Organ donor (organ/tissue donation by the donor)

Click Expand to show legacy content.


edit dx infobox
Category/Organ
System: 		Category: Other Medical (old)

Type:

Medical Problem

Main Diagnosis: Organ Donor
Sub Diagnosis:
Diagnosis Code: 874-00
Comorbid Diagnosis:
Charlson Comorbid coding (pre ICD10):
Program: Critical Care and Medicine
Status: Currently Collected


Major organ donors (ie not just eyes, skin or bones).

This data is reported in the Quarterly report.

Collection process for Organ Donor who has been declared braindead

  • Diagnosis: brain death or death has been declared
  • Patient status: Expired
  • Diagnosis codes: braindead (524) & organ donor (874).
  • Discharge date: date and time patient is sent from ICU to the operating room (see #Background)
  • Discharge to: leave blank
  • Not all Organ Donors have a bronchscopy done, so don't automatically assume and code it. The only time it is done is if there are considering the lungs. This is according to a Respirologist from STB ICU.

Collection process for living Organ Donor (donor and recipient)

Background

Organ donation is the removal of the tissues of the human body from a person who has recently died, or from a living donor, for the purpose of transplanting.

Organs that can be procured include: the heart, intestines, kidneys, lungs, liver, pancreas. These are procured from a brain dead donor or a donor where the family has given consent for donation after cardiac death, known as non-heart-beating donation.

The following tissues can be procured: bones, tendons, corneas, heart valves, femoral veins, great saphenous veins, small saphenous veins, pericardium, skin grafts, and the sclera (the tough, white outer coating surrounding the eye). These are only procured after death.

Organs that can be donated from living donors include part of the liver or pancreas and the kidney.

We are using time patient moved to the OR as discharge time rather than the time brain death is declared in the unit. This was decided when the database program began in the late 1980's because a number of organ donors did not leave ICU for 1-2 days after being declared brain dead and ICU wants to account for bed occupancy and nursing workload for those patients.

For more detailed information about the definition of ORGAN DONATION see:

http://en.wikipedia.org/wiki/Organ_donation

http://en.wikipedia.org/wiki/Non-heart_beating_donation

http://www.organtransplants.org/understanding/

Template:CCMDB Data Integrity Checks

Template:Discussion

Organ Donors must be status deceased

  • For all brain dead(524) diagnoses at HSC or STB, outcome must be "expired"

Organ Donors must be diagnosis brain dead

  • If 874(organ donor) Admit or Complication slots, then 524 braindead
  • If the two have to happen together should they not just be combined, or one be considered to always be present if the other is? I think we have some other dxs where we don't code the implied conditions, no?Ttenbergen 16:03, 2012 April 16 (CDT)
    • well, braindead does not guarantee proceeding to organ donor (874)Trish Ostryzniuk 17:14, 2012 April 16 (CDT)
      • no, but it sounds like organ donor guarantees brain dead; so, why does it not go without saying?Ttenbergen 17:30, 2012 April 16 (CDT)
        • yes, as of 2009, we are only coding major organ donors, so yes, if organ donor, then must have been declared brain dead.Trish Ostryzniuk 17:33, 2012 April 16 (CDT)
          • So what is the benefit of still coding brain dead in organ donors? Ttenbergen 09:36, 2012 April 17 (CDT)

Legacy Data

  • January 23.09-as per Dr. Roberts-Only code MAJOR ORGAN donors. We will no longer code eyes, skin or bones donors in the database. TOstryzniuk 19:30, 23 January 2009 (CST)
  • discharge-to used to be to OR; we implemented data integrity checks to prevent discharging dead people to locations; it will be assumed that if a patient is coded as on organ donor (code 874) that he went to the OR for organ harvesting.
following comes from ! Automated Data Integrity Checks, not integrated yet.

Q6.?? - Organ donors must be brain dead

Programming Status - Complete

Query Generated and posted

  • what does generated and posted mean? Where is it posted?--TOstryzniuk 09:43, 20 March 2009 (CDT)
    • waiting for reply from Tina.--TOstryzniuk 21:58, 14 April 2009 (CDT)

Q6.?? - If 874 discharged to should be blank

Word document read: "If code 874 in Admit slot, discharge to destination should be blank.

  • I am not sure why this is even a check? All 874's go the the OR for organ donation. The problem is with CCMDB where if DX is 524 and outcome = expired then discharged to is NOT allowed, so collectors are putting outcome = Survived so that they can fill in the Discharge TO. All 874 and or 524 are Expired. Many brain dead patients (524)are sent to HSC or STB for second assessment for brain death. Some proceed to organ donation, others do not.
  • 874 is not used for live donors.
  • see braindead & Organ Donor itemTOstryzniuk 19:38, 28 October 2008 (CDT)

Discussion

  • If 874 includes live donors this will result in false positives which should be documented. If 874 does not include live donors, then it might be more relevant to check that they are deceased rather than that their discharged-to is empty. Access already traps any deceased with a discharge-to. Ttenbergen 17:33, 24 October 2008 (CDT)

Programming status - Complete

Query Generated and posted (zero cases) – if I extend it to older cases there are a few HPs in the discharge-to.

Q6.?? - 874 and 524 should not be admitted from OR

If code 874 and 524 in Admit slots, the admitted From should never be OR.

Programming Status - Complete

Discussion

TRISH HERE: OCT 28.08 1900 hrs.

  • After consulting Roberts, changes as follows:
  • Someone (Trish?) added the following:
    1. if braindead (524) at community site (GRA, VIC, CON, OAK) and sent to teaching site (HSC, STB) then outcome for both Community& teaching site = Expired. Admit DX 1 for teaching site = braindead (524).
    • CCMDB.mdb doesn't allow a deceased person to be discharged somewhere. Julie and I discussed this because she had initially requested this check. Ttenbergen 17:33, 24 October 2008 (CDT)
    • Where or how would a patient status be set to "D" for donor? I don't think "D" is currently an option.Ttenbergen 17:33, 24 October 2008 (CDT)
    • Once the other two issues are addressed, could you maybe re-word the above rule by adding brackets around the clauses that belong together, because as it is, it is difficult to figure out if the last IF refers to the entire beginning of the sentence or just part of it. Don't have to use brackets, you might be able to clear it up otherwise. Ttenbergen 17:33, 24 October 2008 (CDT)
  • Need more input- currently in discussion with ICU & Julie TOstryzniuk 18:16, 22 October 2008 (CDT) Template:Discussion
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