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), [[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]]
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

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 Property "DICRelatedConcepts" (as page type) with input value "Kidney, acute renal failure NOS" contains invalid characters or is incomplete and therefore can cause unexpected results during a query or annotation process., Property "DICRelatedConcepts" (as page type) with input value "Kidney, acute renal failure, postprocedural" contains invalid characters or is incomplete and therefore can cause unexpected results during a query or annotation process., Property "DICRelatedConcepts" (as page type) with input value "Kidney, acute tubular necrosis (ATN)" contains invalid characters or is incomplete and therefore can cause unexpected results during a query or annotation process., Property "DICRelatedConcepts" (as page type) with input value "Kidney, renal failure/insufficiency/uremia, unspecified as acute or chronic" contains invalid characters or is incomplete and therefore can cause unexpected results during a query or annotation process.

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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

Concept:Acute renal failure:

• 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

The list of these is long and incomplete; at this point it looks as though the check that every TISS dialysis entry should have a corresponding dx is not reasonable.

all #Dialysis requiring Dxs plus: 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 Hyperkalemia Congestive heart failure with pulmonary edema Fluid overload Metabolic acidosis: Acidosis, NOS or Kidney, renal tubular acidosis (RTA, all types) Drug overdoses and poisonings -- the main ones are: Aspirin & other salicylates -- Aspirin or other salicylate or NSAID, overdose/toxicity Valproic acid, carbemazepine (Tegretol), phenytoin (Dilantin), barbiturates -- Antiseizure drug NOS, overdose/toxicity Metformin -- Insulin or other antidiabetes drug, overdose/toxicity Lithium -- Psychiatric drug NOS, adverse effect Theophylline -- Drug or biological substance/agent NOS, overdose/toxicity Alcohols -- Alcohol (ethanol), poisoning by non-pharmaceuticals or Toxic alcohols, poisoning by non-pharmaceuticals Diltiazem -- Calcium channel blocker, overdose/toxicity Occasionally a few others (rare)

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:

• at least one of #Dialysis TISS Items
• doesn't have one #Dialysis qualifying Dxs

Reality check

AG REPLY -- This is challenging since not everyone with either ARF or CRF gets dialysis AND not everybody who gets dialysis has renal failure -- e.g. dialysis is also occasionally used for drug overdoses, volume overload, and a very few other things.

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