Allan's links

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Allan offered to help us out with the ICD10 documentation. Here are a few links to get started.

specific questions for Allan

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  • current # of questions: 28
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Reporting from ICD10/CCI
  • We made this page early on to make sure that we address any reporting concerns you have about ICD10. Are the TASK questions still relevant? If not, could you please take them out? If you have other things relating to this that should go to task, pls stick them in here.

Will Julie be able to come up with usable groupings of diagnoses? In the current system she grouped by main diagnosis, but that concept is gone. Will ICD10 blocks implemented by S ICD10 Block Dxs table be sufficient? Ttenbergen 22:57, 2018 March 20 (CDT)

  • Different procedures would be listed with the same CCI code; will Julie easily interpret and utilize CCI codes for reporting?
  • Do we care that we will not be able to differentiate between a Blakemore tube from an Upper GI scope with banding or hemostasis, when in CCI they both look the same: (T) Stomach, pylorus... and Control of Bleeding. --LKolesar 14:11, 2018 May 1 (CDT)
    • discussed at task 14:08, 2018 June 20 (CDT), Julie to review what she needs and we will discuss again Ttenbergen 14:08, 2018 June 20 (CDT)

This is part of the discussion with Julie about Apache diagnoses today I think Ttenbergen 08:49, 2019 January 10 (CST)
10 January 2019 14:49:53Ttenbergen
Toxic alcohols, poisoning by non-pharmaceuticals
  • I find the segment "poisoning by non-pharmaceuticals" confusing. Isopropyl alcohol for example has some pharmaceutical uses as a disinfectant. I think we should remove this phrase in both of the options that contain them for the reason that the phrase is unnecessary and confusing. Just leave as follows: Alcohol (ethanol) poisoning and Toxic alcohols poisoning. (LKolesar) 2019-02-12
13 February 2019 23:10:08Ttenbergen

  • Just to clarify: when a patient has septic shock and we put in the pathogen from a positive blood culture, do we also have to code bacteremia? OR is this code only for positive blood cultures where the source is not known?--LKolesar 14:20, 2019 February 12 (CST)
13 February 2019 23:25:34Ttenbergen
Transfusion of FFP
  • Dr. Garland contacted Canadian Blood services - 250mL of FFP is counted as 1 unit and has 1 sticker. Therefore, count stickers if available, otherwise use the volume of FFP if that is all that is charted.
    • How would one derive a "count units" from the volume on the chart? e.g. if a pt got 25ml would you count that as a 0.1?

You asked me to put how to count this on your list at Task 2019-02-06
13 February 2019 18:52:07Ttenbergen
Task Team Meeting - Rolling Agenda and Minutes 2019Charlson Admit Como - I have put several related pages on your list that start with the same words as this one. We need to update them to make sense with any change to this. Some still had other questions in them anyway.
  • AG REPLY --- tina and ag to go through all the separate ICD10 codes Charlson Comorbidities in ICD10 codes that make up the 17 Charlson conditions and one by one decide if they can be included in Charlson EVEN IF they're admit or acquired diagnoses.
    as per your request that page is still waiting for an edit from you
13 February 2019 20:00:42Ttenbergen
S ICD10 Charlson Como patterns tableCharlson Admit Como - this is part of that discussion - if we want to limit some of these to not being allowed as admits, it will likely have to be done here.
  • AG REPLY --- yes we can and should go through ALL ICD10 codes and indicate which of the 3 Dx Types they're allowed in. AG needs to be reminded to deal with this around June 2019
  • 1 February 2019 19:10:21Ttenbergen
    Comorbid DiagnosisCharlson Admit Como - this is part of that discussion - if we limit which admits will count as comos we need to review13 February 2019 19:20:47Ttenbergen
    Admit DiagnosisCharlson Admit Como - this is part of that discussion - if we limit which admits will count as comos we need to review31 December 2018 21:09:29Ttenbergen
    Controlling Dx Type for ICD10 codesnot needed at go-live; Need to export the list and plan process that includes the extra items below. To export, see S_ICD10_table#Query_to_populate_s_ICD10_table_from_wiki.
    Charlson Admit Como - this is part of that discussion
  • I have emailed Allan the table with all Dxs to set them as Como_allowed, Admit_allowed, Acquired_allowed. Will set up infrastructure to contain this once I have data. Ttenbergen 12:31, 2019 February 13 (CST)
  • 13 February 2019 18:31:37Ttenbergen
    Palliative careDo you mean Admit Diagnosis or Comorbid Diagnosis? Both are before admission1 February 2019 17:55:51Ttenbergen
    S AP ChronicDx grouping3 January 2019 23:28:16Ttenbergen
    Non-standard ICD10 DiagnosesDx grouping 3 January 2019 23:32:15Ttenbergen
    APACHE Acute DiagnosesDiabetes_mellitus_chronic_complication:_Musculoskeletal

    is selected by the line

    • ns_Z1 Renal/Metabolic NOS NOT admitted to ICU postoperatively AND Any admit diagnosis is N00.^-N39.^, E00.^-E90.^

    In your excel sheet.

    It is a chronic code sort of by definition, so hopefully no one would code it as an admit, but for now they could. And if they did, it would give them APACHE Dx (not como) points.

    Is that really as intended? I suppose even as a chronic code it is a marker for the presence of diabetes, so it wouldn’t necessarily be wrong, but it seems odd, so flagging it.
    need here some general info what these are, links to wiki articles they are actually related to under old coding scheme, etc. I need help with this because I don't know if any of this is on the wiki, or else what it is about. Ttenbergen 17:20, 2018 February 23 (CST)
    Dx grouping

    There would be no way to exclude post-first-48hr Acquireds from the calculation. Do we care? Or should this only be Admits?
    3 January 2019 23:31:35Ttenbergen
    Chronic Health APACHEDx grouping
    • AG REPLY -- Tina I don't know what the question is here.
      • just flagging it to sort with the others so we can deal with it when we address them.
    3 January 2019 23:31:12Ttenbergen
    Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5How do you code patients with ESRD,who are being worked up for HD, and they present with "acute on chronic RF"? I used Kidney, acute renal failure NOS in admits, Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5 in comorbs, and HD in acquired CCI's. However, I'm getting an error with the APACHE ARF if I put "yes", because of the chronic RF code in comorbs. How should these types of patients be coded, so we are all doing it consistently? --Jvelasco 10:18, 2019 February 7 (CST)
  • AG REPLY -- if you have Stage 5 CRF, even if not yet on dialysis, you CANNOT get any sort of acute renal failure unless you have had a renal transplant. Thus you situation is not really acute on chronic renal failure. If the Stage 5 was existing before admission, i.e. based on a prior creat clearance<15 mL/min, then it should be a comorb even if not prev dialyed. The acute admission then is going to be for either: (i) something such as hyperkalemia or fluid overload or uremia etc, i.e. a complication of the ESRD OR if they REALLY are being admitted for the Stage 5 (e.g. to install an A-V fistula in their arm and a Vascath), then the Stage 5 CRF should ALSO be an admit dx.
  • 11 February 2019 20:47:52Dr. Allan Garland
    General Diagnosis Coding GuidelinesThis is the page I referred to that I wrote up ages ago with the intent that we would first consider if it already resolves quesetions asked on the wiki, before giving specific answers. It never took off. Is it time to re-consider it? If not, is it time to delete this?
    I have linked this from Critical Care and Medicine Database Core Curriculum, but it likely needs updating. Unless we don't want it at all.
    4 January 2019 03:05:26Ttenbergen
    Hereditary coagulation factor VIII deficiency (classic hemophilia A)I made the category Hemophila since Disease of blood or blood-forming organ, NOS had it as an SC and I needed to be able to link it. Is the list now grouped complete? If not, pls add the tag below this question to other pages as appropriate.3 January 2019 23:02:36Ttenbergen
    Cardiac pacemaker or defibrillator, has oneWhen a patient is admitted that has a pre-existing LVAD and has had it for months to years, do you capture this in the database somehow? There is no comorbid entry for VAD, “has one” , like it does for other things like permanent pacer or ICD. If the diagnosis is related to the VAD itself (like a mechanical failure), we can use iatrogenic mechanical failure. If the diagnosis is something else, do you care if the pt has a VAD? We cannot put it in CCI because it is out of our time frame. Just checking as this has come up a few times before and we always struggle with how to code the pre-existing “permanent” VAD patient. -- Laura Kolesar - Feb 7.197 February 2019 17:12:20Trish Ostryzniuk
    ICD10 Guideline for drugs and substancesfix SMW to include templates
    You asked me at Task Team Meeting - Rolling Agenda and Minutes 2019#ICU Database Task Group Meeting – February 6, 2019 to add a page to wiki to explain how Intravenous Drug Abuse (IVDA) would be coded. Instead of adding a page, I think this might be a good fit, and it's already linked from substance pages.
    7 February 2019 14:46:12Ttenbergen
    SVD (Spontaneous vaginal delivery)You said "And yes, we could link them." How would we do that, and should we do that?1 January 2019 01:43:27Ttenbergen
    Check ICD10 some cant be primaryCategory:Mechanism would need to be excluded as well, and so would past history, and quickly the list gets so large again that we are back at discussing Controlling Dx Type for ICD10 codes where we should simply include "Primary"-ability.6 February 2019 05:20:29Ttenbergen
    S ICD10 APACHE Dx patterns tabledx grouping if you have a reference, ideally online, for what you used to make the APACHE comorbid ranges, please add it here.3 January 2019 23:30:57Ttenbergen
    Temporary page to list dxs documented as requiring treatment to be codeddxs documented as requiring treatment to be coded13 February 2019 23:05:22Ttenbergen
    List of diagnoses affecting Overstay Project (pre-ICD10)in reconciling these, a lot are based on Charlson Comorbidities in ICD10 codes, so whatever we use there should be consistent with here.6 February 2019 06:53:05Ttenbergen
    (D) Intervertebral Discis this bone/joint or soft tissue. see similar question about cartilage in one of these other procedures, search wiki for cartilate.3 January 2019 21:39:43Ttenbergen
    Central Lineq
    • How do we code tunnelled line insertions in Interventional Radiology? It is captured on the TISS as a trip out of ICU, so is it enough to just use the CCI code CVC placement, any location? --Jvelasco 11:43, 2019 February 8 (CST)
    13 February 2019 20:15:26Ttenbergen
    Bypassq PEG insertion is also on the Implantation of Internal Device page. Which should we use? Bypass or internal device?--Jvelasco 11:25, 2019 February 8 (CST)13 February 2019 20:14:31Ttenbergen
    Illicit drug useyou were going to review whether this should be used for intravenous drug abuse as per Task Team Meeting - Rolling Agenda and Minutes 2019#ICU Database Task Group Meeting – January 24, 20196 February 2019 04:34:52Ttenbergen
    Swiss Army Knife.svg

    need to update this to list templates

    [[:Template:+]] [[DiscussWho::Allan]] OR
    [[:Category:+]] [[DiscussWho::Allan]]