ARI: Difference between revisions

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(discussed at Task today)
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*''A Rise >100 mmol from baseline over 24 hours'''
*''A Rise >100 mmol from baseline over 24 hours'''
* a patient is '''not''' on chronic hemodialysis or peritoneal dialysis
* a patient is '''not''' on chronic hemodialysis or peritoneal dialysis
** If the prior Creatinine level is unknown use > 250 as a guideline to code ARI.


{{Discussion}}
{{Discussion}}
* I don't think that just having a creatinine of >250 should automatically mean ARI.  This could be the patient's baseline and therefore is a chronic issue.  My opinion is to only use the rule of >100 mmol over baseline over 24 hours for '''acute''' renal insufficiency (without dialysis), or use ATN  if this is documented.  --[[User:LKolesar|LKolesar]] 07:13, 2014 October 8 (CDT)
** Are we to change what we have being doing for over 10 years ?--[[User:PStein|PStein]] 09:54, 2014 October 15 (CDT)
*** I am just putting my opinion here, if any changes are done they will have to go through the task group first.--[[User:LKolesar|LKolesar]] 11:28, 2014 October 15 (CDT)
****I always check what the pts baseline creatinine was prior to admission if the pt had chronic renal insuffiency  and creatinine was 250 last admission I will code as mod CRI if the present creatinine was say 350 I will code acute RI in admits and CRI in comorbids ( acute on chronic )If the creat was the same as last admission  say 250 and pt has CRI I only code in comorbids because it is not acute.-[[Shirley Kiesman]]
*****This is what I do also.  This makes sense to me, not arbitrarily putting a value of >250 as acute renal insufficiency.--[[User:LKolesar|LKolesar]] 17:29, 2014 October 15 (CDT)
******remove the 250 value from the definition. ~~Judy Kublick oct 16, 2014
** I don't actually see a 250 in the core definition above... Ttenbergen 12:11, 2015 March 30 (CDT)
**You are right Tina, not sure if this had been changed since these comments were made (IN OCT 2014)or if comments were made in error.  Just need to clean up the comments here I think.  --[[User:LKolesar|LKolesar]] 12:24, 2015 March 30 (CDT)
** I think this may actually have been about some content in [[:Category:Renal insufficiency]], which isn't where that detail should have gone in the first place... Ttenbergen 10:38, 2015 April 2 (CDT)


{{discuss@task}}
****I always check what the pts baseline creatinine was prior to admission. IF creatinine was 250 last admission I will code as ARI if the present creatinine was say 350. In the pt's history if pt has been running high creatinine levels remember to code in the COMORBID section according to the guideline (Mild or mod)
Discussed at task meeting today. Allan Garland will discuss what categorization to use with the nephrologists. Likely something like [Acute_kidney_injury#Staging RIFLE]. He will report back at next task meeting. Ttenbergen 14:32, 2015 July 9 (CDT)


== {{Data Integrity Checks}} ==
== {{Data Integrity Checks}} ==

Revision as of 08:39, 2016 March 31

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:Kidney, acute renal failure NOS

Click Expand to show legacy content.


edit dx infobox
Category/Organ
System: 		Category: Renal (old)

Type:

Category: Medical Problem (old)

Main Diagnosis: Acute Renal Insufficiency
Sub Diagnosis:
Diagnosis Code: 36400 - ARI-Acute Renal Insufficiency
Comorbid Diagnosis: No
Charlson Comorbid coding (pre ICD10): 0 - 2
Program: Critical Care and Medicine
Status: Currently Collected


see Renal Insufficiency-moderate (Cr greater than 240) and Renal insufficiency-mild (creatinine 160-240 mmol) for the related comorbid codes

Acute Renal Insufficiency

Guideline

  • A Rise >100 mmol from baseline over 24 hours'
  • a patient is not on chronic hemodialysis or peritoneal dialysis
    • If the prior Creatinine level is unknown use > 250 as a guideline to code ARI.

Template:Discussion

        • I always check what the pts baseline creatinine was prior to admission. IF creatinine was 250 last admission I will code as ARI if the present creatinine was say 350. In the pt's history if pt has been running high creatinine levels remember to code in the COMORBID section according to the guideline (Mild or mod)

Template:Data Integrity Checks

There are a number of coding rules related to renal diagnoses, centralized info about them is in Renal Coding Considerations.

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