Dialysis Tasks

Under our collection for tasks we collect hemodialysis and peritoneal dialysis. Since the directions are largely the same, this article contains instructions for both.

Only mark a task as performed if it was done during a patients stay on your ward. If a task was done prior to patient coming to your ward or after patient is transferred to another ward, it should be marked as no or none during the stay on your ward.

Dialysis

Patients who have underlying CRF are on chronic hemodialysis or peritoneal dialysis, if they go for a kidney transplant and develop a complication of rejection, hyper K+ or renal failure etc., post kidney transplant and subsequently require dialysis, this will be considered acute dialysis.

Not all pts with DX of ARF or CRF in comorbids have their dialysis during ward admission, particularly if they are a short stay (less than 4 days). Pt is sent to other wards for their dialysis, therefore it may be correct that there might not be a dialysis acute or chronic TASK is marked.

Hemodialysis Task

• possible entries: (none, acute, chronic)
  • Acute – first time dialysis ever, during this hospital admission (page 32 in Dx code book). ACUTE dialysis is 1st time dialysis during this hosp admission.
  • Chronic - dialysis which was being done on an outpatient basis prior to this hospitalization

Peritoneal Dialysis

• possible entries: (none, acute, chronic)
  • Acute – first time peritoneal dialysis ever, during this hospital admission
  • Chronic - dialysis which was being done on an outpatient basis prior to this hospitalization or patient was doing on their own at home prior to this hospitalization

Discussion

Change of Dialysis status during admission - Chronic or Acute?

• Renal Transplant patients who are on peritoneal dialysis are 99% of the time are given chronic peritoneal dialysis prior to surgery. Following their Renal Transplant they may have delay of graft function, as a complication,and require acute peritoneal dialysis. In this case, I can only capture one task: chronic or acute. Because the acute event is more Relevant, I have been capturing only the acute peritoneal dialysis.

• Is it clear, that pts with CRF as a comorbidity, who have a Renal Transplant, will usually not require dialysis for their remainder of hospital stay.--FLindell 15:14, 14 September 2009 (CDT)--FLindell 15:14, 14 September 2009 (CDT)

Dialysis Examples

Example 1:

• I have a patient that was admitted to my floor from another medical floor. The patient was a chronic h.d. patient prior to admisssion. A week or two after admission (while still on the first medical floor), the patient was switched to p.d. For my admission I put h.d. chronic, and p.d. acute. This patient has now switched back and forth between h.d., and p.d. on an almost weekly basis. How do I code the dialysis tasks now that she has gone back and forth with both?--DPageNewton 15:55, 15 October 2008 (CDT)
  • HD Chronic & PD Acute or not mutally exclusive therefore you can mark both in TASKS if both are occurring while patient is on your ward.--TOstryzniuk 00:40, 19 November 2008 (CST)

Example 2:

• Patient came from ER with CRF and was receiving outpatient peritoneal dialysis (PD). Pt developed shock and was sent to ICU where he had Hemodialysis. On your ward the pt had peritoneal dialysis done once before going to ICU.
  • You would mark CHRONIC PD as a TASK. You would not mark ACUTE HD. This is being done during his ICU stay.

Example 3:

• Pt came from ER to your ward with CRF (on outpatient PD dialysis). Pt had to be switched to hemodialysis because of peritonitis.
  • Peritoneal dialysis should be marked chronic if patient had peritoneal dialysis done one or more times while on your ward. Switched to hemodialysis which is new and should therefore be marked as acute.

Example 4:

• An ICU patient with ARF receiving acute hemodialysis in ICU, comes to your ward from the ICU and expires within a day or two. No dialysis was ever done for the short time patient was on your ward.
  • The hemodialysis task should be marked as none.

Data Integrity Rules

There are data integrity rules related to this task, see ! Automated Data Integrity Checks#Checks for Medicine for more details.

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