Query check CCI ICD10 Dialysis no Dx

If there is a TISS28 entry for Hemodialysis there should be a corresponding Dx.

• 32 Intermittent Hemodialysis (even if pt goes to dialysis unit)
• 33 CRRT
• 34 Peritoneal Dialysis

CRF/ARF vs TISS28 items 32, 33, 34

Has ARF/CRF but not Dialysis

If meets following the entry is an error:

• ICU patient
• LOS>3
• at least one of dxs ([ARF (Diagnosis)]](350), CRF - Chronic Renal Failure(351), Acute Tubular Necrosis (ATN)(352), Nephrotic Syndrome(355))
• doesn't have one of (T33/34/35) in TISS28

TISS implies dx

If meets following the entry is an error:

• ICU patient
• LOS>3
• at least one of (T33/34/35) in TISS28
• doesn't have one of dxs ([ARF (Diagnosis)]](350), CRF - Chronic Renal Failure(351), Acute Tubular Necrosis (ATN)(352), Nephrotic Syndrome(355), Hepatorenal Syndrome(356), Pt Monitored while on Dialysis (398), ( a bunch of toxicities? eg TCA (Tricyclic) 450-499), Hyperkalemia K Greater Than 6.5 (327), Rhabdomyolysis (Myoglobinemia) (357))

Reality check

• Collectors can you see a scenario where this would not be an error? If not, this could be added to Change Priorities. Ttenbergen 20:17, 2014 April 30 (CDT)Template:Potential Change
  • codes 350 through 355 all pertain to ARF, however the other remaining codes are not correct, as they do not necessarily mean that dialysis is started Lisa Kaita 12:03, 2017 April 25 (CDT)
    • So there are codes that might have dialysis, and codes that would have dialysis, right? I updated the two listings above. If pt has a dialysis-mandatory dx, must have TISS. If a pt has TISS, must have a dialysis-optional dx. Does the list of dxs in each case look right now? And, can you think of scenarios where these errors would lead to false positives? Ttenbergen 17:12, 2017 April 26 (CDT)

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.