Allan's links

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

• The plan how we want to implement: Conversion from our old diagnosis schema to ICD10/CCI

specific questions for Allan

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Automatically generated list

• current # of questions: 31

	Question	Modification date "Modification date" is a predefined property that corresponds to the date of the last modification of a subject and is provided by Semantic MediaWiki.	Last editor is "Last editor is" is a predefined property that contains the page name of the user who created the last revision and is provided by Semantic MediaWiki.
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 14:49:53	Ttenbergen
HD (Hemodialysis)	I need clarification on this one-if a patient is either dialysed in Emerg, or on a different ward, (ie. anytime during the current hospitalization prior to coming to your area), are we to enter this only as an admit CCI?Mlagadi 10:26, 2019 February 11 (CST) Please have a look at Admit Procedure, it should explain whether to code a procedure or not. There is no explicit exception for Dialysis. If the info there does not give you the answer you need, please elaborate. If the info is there, then, would you have looked there? How can we make clearer to look there? Ttenbergen 11:53, 2019 February 13 (CST) We used to have a special procedure for indicating if a renal transplant patient received dialysis post transplant under the tasks. If we are now only coding HD once, it will often be missed if the patient required HD post renal transplant. Do we care about collecting this information? There is the post procedural renal failure code that will be coded in the acquireds, but this does not automatically mean that they received dialysis. AG REPLY -- I don't see any special reason to need this info. Unless Julie tells us it's being requested, I think we can do without it. Julie, what are your thoughts on this? Ttenbergen 11:53, 2019 February 13 (CST)	13 February 2019 17:53:56	Ttenbergen
Task Team Meeting - Rolling Agenda and Minutes 2019	Charlson 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 20:00:42	Ttenbergen
S ICD10 Charlson Como patterns table	Charlson 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 19:10:21	Ttenbergen
Admit Diagnosis	Charlson Admit Como - this is part of that discussion - if we limit which admits will count as comos we need to review	31 December 2018 21:09:29	Ttenbergen
Comorbid Diagnosis	Charlson Admit Como - this is part of that discussion - if we limit which admits will count as comos we need to review	13 February 2019 19:20:47	Ttenbergen
Controlling Dx Type for ICD10 codes	not 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 18:31:37	Ttenbergen
Charlson Comorbidities in ICD10 codes		14 February 2019 23:10:04	Ttenbergen
Palliative care	Do you mean Admit Diagnosis or Comorbid Diagnosis? Both are before admission	1 February 2019 17:55:51	Ttenbergen
Acute myocardial infarction complication of Dressler's syndrome (postmyocardial infarction syndrome)		13 February 2019 20:20:34	Ttenbergen
S AP Chronic	Dx grouping	3 January 2019 23:28:16	Ttenbergen
Non-standard ICD10 Diagnoses	Dx grouping With our addition of codes, collectors may use one of our codes rather than the closest standard ICD10 code. In that case, the dx would not show up in the range. How should we address this? The most likely candidates above seem Bronchiolitis obliterans organizing pneumonia (BOOP, cryptogenic organizing pneumonia (COP)) and SARS (severe acute respiratory syndrome) AG REPLY -- for this nonstd BOOP code, there are no existing issues regarding any of the comorbid groups (e.g. Charlson) Allan, could you confirm that that this is what we found when we looked into BOOP. Dx grouping Would there be a problem with SARS (severe acute respiratory syndrome) causing APACHE Acute Dxs in ICD10 codes to not be counted? It includes Respiratory infections. Ttenbergen 21:01, 2018 April 24 (CDT)	3 January 2019 23:32:15	Ttenbergen
APACHE Acute Diagnoses	Diabetes_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 23:31:35	Ttenbergen
Chronic Health APACHE	Dx 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 23:31:12	Ttenbergen
Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5	How 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 20:47:52	Dr. Allan Garland
General Diagnosis Coding Guidelines	This 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 03:05:26	Ttenbergen
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 23:02:36	Ttenbergen
Mediastinitis, infectious		13 February 2019 22:37:03	Ttenbergen
Stimulants incl methamphetamine, acute intoxication		13 February 2019 18:43:56	Ttenbergen
Pain, chronic NOS		13 February 2019 17:58:15	Ttenbergen
Cardiac pacemaker or defibrillator, has one	When 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 7.19	7 February 2019 17:12:20	Trish Ostryzniuk
ICD10 Guideline for drugs and substances	fix 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 14:46:12	Ttenbergen
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 18:52:07	Ttenbergen
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 01:43:27	Ttenbergen
Check ICD10 some cant be primary	Category: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 05:20:29	Ttenbergen
S ICD10 APACHE Dx patterns table	dx 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 23:30:57	Ttenbergen
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 06:53:05	Ttenbergen
(D) Intervertebral Disc	is this bone/joint or soft tissue. see similar question about cartilage in one of these other procedures, search wiki for cartilate.	3 January 2019 21:39:43	Ttenbergen
Ventricular fibrillation		13 February 2019 23:07:25	Ttenbergen
Bacteremia	what do you mean by free-standing? Do you mean not to use Combined ICD10 codes? Bacteremia is in Category:Infection requiring pathogen, so it has to be coded with a pathogen. Do you mean it should be coded with Infectious organism, unknown or similar? Ttenbergen 13:36, 2019 February 1 (CST); 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 23:25:34	Ttenbergen
Illicit drug use	you 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, 2019	6 February 2019 04:34:52	Ttenbergen

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