Check Renal Tasks

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• Explanation: Collection of Tasks Elements was discontinued as part of move to ICD10/CCI.
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Review for ICD10/CCI

Allan-Have you heard back from Nick about whether tasks and special cross checks will still be required in ICD10?

dx implies task

If a medicine patient has LOS >= 3

• HD or PD task is required if all of the following are true:
  • one of the following is present:
    • comorbid CRF
    • diagnosis ARF
  • Renal Transplant (80504 or 80505) is not present
    • you can have a renal transplant in comorbid and HD or PD task can still be checked as a patient with a failed renal transplant can require dialysis again Lisa Kaita 12:04, 2017 April 26 (CDT)

which dxs?

• 350 ARF (Diagnosis)

• 351 CRF - Chronic Renal Failure as comorbid

task implies dx

If a medicine patient has LOS >= 3 and has a HD or PD task then must have one of the following dxs:

• comorbid CRF
• diagnosis ARF

which dxs?

• 350 ARF (Diagnosis)

• 351 CRF - Chronic Renal Failure

Questions prior to implementing

excluding community hospitals

Apparently neither HD nor PD is done at community hospitals.

• Dialysis Task must never be marked for
  • GRA N3/N5/W3
  • VIC N5/S3/S4/S5

• Since we only check patients with LOS>3, do we need to consider this? If a pt with CRF/ARF is in hospital longer than 3 days would dialysis not need to be accommodated? IE, would the patient then not need to be sent to a different hospital that can dialyze? Ttenbergen 21:02, 2014 April 30 (CDT)
  • there are exceptions: If Grace and VIC Med send patient for dialysis to HSC or STB, then they return back to medicine bed, TASK will be marked with dialysis for their site. (As per Trish, I think)
    • Except those, community sites should not have dialysis task, right? Ttenbergen 17:14, 27 October 2008 (CDT)
  • So these locations would not admit patients who are, say, on home peritoneal dialysis?
    • DC never encounter such case
      • at the Grace those patients with CRF ie on HD or PD are not admitted here, we have had one case where a patient was transferred to HSC for acute HD and then transferred back to the Grace, this was many years ago, not sure about the VGHLisa Kaita 12:20, 2017 April 26 (CDT)

Would this be a proper summary for the above:

• HD and PD are not done at community hospitals
• task might still be coded if pt is sent to other site for it
• the check would apply for GRA/VIC just like other sites:
  • if pt needs PD/HD, they need it, so they won't be kept for >3 days without

palliation?

• Could any of (e) or (f) be OK if the patient is palliative? (Tina)
  • Yes. Found cases of palliative with dialysis. (Julie)
    • Yes, but could a palliative patient not also arrive and not get dialysis even if they are CRF? (Tina)
      • yes we have cases where this has occurred, ie CRF in comorbid but no dialysis task entered if not dialyzed during the admission secondary to palliationLisa Kaita 12:25, 2017 April 26 (CDT)
        • Would all the pts like this have either Palliation or Comfort Care marked? That would mean I could exclude them from the check "if you have dx you must have task"...

Renal Transplant not present

If 351 in comorbid Dx AND Admit DX 1 = 893 (pre op admission) AND complication = 805-4 or 805-5 then TASK DIALYSIS should not be marked.-PTorres 16:06, 21 October 2008 (CDT). Not sure if Julie applies this detail or not.Trish Ostryzniuk 11:45, 2014 February 4 (CST)

• No dialysis prior to transplant while waiting in hospital? No dialysis after transplant if things go wrong? That restriction could lead to errors being listed. Ttenbergen 12:37, 2014 May 5 (CDT)

Implementation

Hardcoded in query Check_Renal_Tasks in CCMDB.accdb. This will need to be changed!

Start Date

TBA, once discussion above is resolved

Status

being implemented once discussion is resolved

See also

• Renal Coding Considerations (old)
• Dialysis Tasks

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