Query check CCI ICD10 Dialysis no Dx: Difference between revisions

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{{Data Integrity Check
{{Data Integrity Check
|DIC_summary=If there is a [[TISS28]] entry for Hemodialysis there should be a corresponding Dx.
|DIC_summary=If a profile has one of the [[#Dialysis CCI Items]] there should also be one of the [[#Dialysis qualifying Dxs]].
|DIC_related_concepts=Intermittent hemodialysis (TISS Item); Peritoneal dialysis (TISS Item); CRRT (TISS Item); {{#ask: [[Concept:Acute renal failure]]|default=none found|format=plainlist|link=none|limit=100|sep=;}}
|DIC_related_concepts= Peritoneal dialysis (TISS Item); CRRT (TISS Item); Intermittent hemodialysis (TISS Item); {{#ask: [[Concept:Acute renal failure]]|default=none found|format=plainlist|link=none|limit=100|sep=;}}; Kidney, acute renal failure, postprocedural;Kidney, acute renal failure NOS;Kidney, acute tubular necrosis (ATN);Hyperkalemia, severe or symptomatic;Congestive heart failure with pulmonary edema;Fluid overload;Acidosis, NOS;Kidney, renal tubular acidosis (RTA, all types);Aspirin or other salicylate or NSAID, overdose/toxicity;Antiseizure drug NOS, overdose/toxicity; Insulin or other antidiabetes drug, overdose/toxicity;Psychiatric drug NOS, adverse effect;Drug or biological substance/agent NOS, overdose/toxicity;Alcohol (ethanol), poisoning;Toxic alcohols, poisoning;Calcium channel blocker, overdose/toxicity
|DIC_firmness=hard check
|DIC_firmness=hard check
|DIC_timing=complete
|DIC_timing=complete
|DIC_coding=query ''NDC_Dxs_vs_TISS_Dialysis''
|DIC_coding=query ''check_CCI_ICD10_Dialysis_no_Dx''
|DIC_implementation_date=2019/01/06
|DIC_implementation_date=2021-10-27
|DIC_status=needs review
|DIC_status=implemented
|DIC_LProblem=No
|DIC_app=CCMDB.accdb
|DIC_app=Centralized data front end.accdb
}}
}}


If a profile has one of the [[#Dialysis CCI Items]] there should also be one of the [[#Dialysis qualifying Dxs]].


{{DiscussTask | We are getting a lot of positives where a requiring dx does not have a TISS. Is our list of requiring dxs reasonable? ~ 118 patients like this. }}
=== Dialysis CCI Items ===
 
*{{ CCIWithCode | CRRT (TISS Item)}}
{{#ask: [[Concept:Acute renal failure]]|default=none found|format=plainlist|link=none|limit=100|sep=;}}
*{{ CCIWithCode | Peritoneal dialysis (TISS Item)}}
 
*{{ CCIWithCode | Intermittent hemodialysis (TISS Item)}}
 
*{{ CCIWithCode | PD (Peritoneal dialysis)}}
If there is a [[TISS28]] entry for Hemodialysis there should be a corresponding Dx.
*{{ CCIWithCode | HD (Hemodialysis)}}
 
*{{ CCIWithCode | CRRT (incl volume removal via PRISMA device)}}
=== Dialysis TISS Items ===
*[[Intermittent hemodialysis (TISS Item)]] (T32)
*[[CRRT (TISS Item)]] (T33)
*[[Peritoneal dialysis (TISS Item)]] (T34)
 
=== Dialysis requiring Dxs ===
<!-- not using [[Concept:Acute renal failure]]: because it includes too much, mild version might not need dialysis -->
* [[Kidney, acute renal failure NOS]]
* [[Kidney, acute renal failure, postprocedural]]
* [[Kidney, acute tubular necrosis (ATN)]]


=== Dialysis qualifying Dxs ===
=== Dialysis qualifying Dxs ===
all [[#Dialysis requiring Dxs]] plus:
*{{ICD10WithCode | Chronic kidney disease (chronic renal insufficiency, uremia) Stage 1, GFR GT 90}}
[[Concept:Chronic Kidney Disease]]:
*{{ICD10WithCode | Chronic kidney disease (chronic renal insufficiency, uremia) Stage 2, GFR 60-89}}
{{#ask: [[Concept:Chronic Kidney Disease]]
*{{ICD10WithCode | Chronic kidney disease (chronic renal insufficiency, uremia) Stage 3, GFR 30-59}}
|default=none found
*{{ICD10WithCode | Chronic kidney disease (chronic renal insufficiency, uremia) Stage 4, GFR 15-29}}
|format=UL
*{{ICD10WithCode | Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15}}
|limit=10}}
*{{ICD10WithCode | Chronic kidney/renal disease, NOS (stage unspecified)}}
*[[Hyperkalemia]]
*{{ICD10WithCode | Kidney, renal failure/insufficiency/uremia, unspecified as acute or chronic}}
*[[Congestive heart failure with pulmonary edema]]
*{{ICD10WithCode | Kidney, acute renal failure, postprocedural}}
*[[Fluid overload]]
*{{ICD10WithCode | Kidney, acute renal failure NOS}}
*Metabolic acidosis: [[Acidosis, NOS]] or [[Kidney, renal tubular acidosis (RTA, all types)]]
*{{ICD10WithCode | Kidney, acute tubular necrosis (ATN)}}
*{{ICD10WithCode | Hyperkalemia, severe or symptomatic}}
*{{ICD10WithCode | Congestive heart failure with pulmonary edema}}
*{{ICD10WithCode | Fluid overload}}
*Metabolic acidosis:  
**{{ICD10WithCode | Acidosis, NOS}}
**{{ICD10WithCode | Kidney, renal tubular acidosis (RTA, all types)}}
*Drug overdoses and poisonings -- the main ones are:
*Drug overdoses and poisonings -- the main ones are:
** Aspirin & other salicylates --   [[Aspirin or other salicylate or NSAID, overdose/toxicity]]
** Aspirin & other salicylates -- {{ICD10WithCode | Aspirin or other salicylate or NSAID, overdose/toxicity}}
** Valproic acid, carbemazepine (Tegretol), phenytoin (Dilantin), barbiturates --     [[Antiseizure drug NOS, overdose/toxicity]]
** Valproic acid, carbemazepine (Tegretol), phenytoin (Dilantin), barbiturates -- {{ICD10WithCode | Antiseizure drug NOS, overdose/toxicity}}
** Metformin -- [[Insulin or other antidiabetes drug, overdose/toxicity]]
** Metformin -- {{ICD10WithCode | Insulin or other antidiabetes drug, overdose/toxicity}}
** Lithium -- [[Psychiatric drug NOS, adverse effect]]
** Lithium -- {{ICD10WithCode | Psychiatric drug NOS, adverse effect}}
** Theophylline -- [[Drug or biological substance/agent NOS, overdose/toxicity]]
** Theophylline -- {{ICD10WithCode | Drug or biological substance/agent NOS, overdose/toxicity}}
** Alcohols -- [[Alcohol (ethanol), poisoning by non-pharmaceuticals]] or [[Toxic alcohols, poisoning by non-pharmaceuticals]]
** Alcohols --  
** Diltiazem -- [[Calcium channel blocker, overdose/toxicity]]
*** {{ICD10WithCode | Alcohol (ethanol), poisoning}}
*** {{ICD10WithCode | Toxic alcohols, poisoning}}
** Diltiazem -- {{ICD10WithCode | Calcium channel blocker, overdose/toxicity}}
** Occasionally a few others (rare)
** Occasionally a few others (rare)


== Checks ==
Allan confirmed that we would not need to add covid because if used in that context, renal failure would also be coded.
=== Has [[#Dialysis requiring Dxs]] but no [[#Dialysis TISS Items]] ===
If meets following the entry is an error:
* ICU patient
* LOS>3
* at least one [[#Dialysis requiring Dxs]]
* '''doesn't have''' any [[#Dialysis TISS Items]]
 
=== Has [[#Dialysis TISS Items]] but no [[#Dialysis qualifying Dxs]] ===
If meets following the entry is an error:
* at least one of [[#Dialysis TISS Items]]
* '''doesn't have''' one [[#Dialysis qualifying Dxs]]
 
== Reality check ==
{{Discuss | who = Julie| question = 
*AG REPLY -- This is challenging since not everyone with either ARF or CRF gets dialysis AND not everybody who gets dialysis has renal failure -- e.g. dialysis is also occasionally used for drug overdoses, volume overload, and a very few other things.}}


== Related articles ==
== Related articles ==
{{Related Articles}}
{{Related Articles}}


[[Category: TISS28 checks]]
[[Category:TISS28 check]]
[[Category: ICD10 Dx check]]
[[Category:ICD10 Dx check]]
[[Category:Dialysis]]

Revision as of 11:05, 2023 November 25

Data Integrity Checks
Summary: If a profile has one of the #Dialysis CCI Items there should also be one of the #Dialysis qualifying Dxs.
Related: Peritoneal dialysis (TISS Item), CRRT (TISS Item), Intermittent hemodialysis (TISS Item), Kidney, acute renal failure NOS, Kidney, acute renal failure, postprocedural, Kidney, acute tubular necrosis (ATN), Kidney, renal failure/insufficiency/uremia, unspecified as acute or chronic, Kidney, acute renal failure, postprocedural, Kidney, acute renal failure NOS, Kidney, acute tubular necrosis (ATN), Hyperkalemia, severe or symptomatic, Congestive heart failure with pulmonary edema, Fluid overload, Acidosis, NOS, Kidney, renal tubular acidosis (RTA, all types), Aspirin or other salicylate or NSAID, overdose/toxicity, Antiseizure drug NOS, overdose/toxicity, Insulin or other antidiabetes drug, overdose/toxicity, Psychiatric drug NOS, adverse effect, Drug or biological substance/agent NOS, overdose/toxicity, Alcohol (ethanol), poisoning, Toxic alcohols, poisoning, Calcium channel blocker, overdose/toxicity
Firmness: hard check
Timing: complete
App: CCMDB.accdb
Coding: query check_CCI_ICD10_Dialysis_no_Dx
Uses L Problem table: not relevant for this app
Status: implemented
Implementation Date: 2021-10-27
Backlogged: true
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If a profile has one of the #Dialysis CCI Items there should also be one of the #Dialysis qualifying Dxs.

Dialysis CCI Items

Dialysis qualifying Dxs

Allan confirmed that we would not need to add covid because if used in that context, renal failure would also be coded.

Related articles

Related articles:
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