Query check CCI ICD10 Dialysis no Dx: Difference between revisions

From CCMDB Wiki
Jump to navigation Jump to search
mNo edit summary
(86 intermediate revisions by 5 users not shown)
Line 1: Line 1:
If there is a [[TISS28]] entry for Hemodialysis there should be a corresponding Dx.
{{Data Integrity Check
*32 Intermittent Hemodialysis (even if pt goes to dialysis unit)
|DIC_summary=If a profile has one of the [[#Dialysis CCI Items]] there should also be one of the [[#Dialysis qualifying Dxs]].
*33 CRRT
|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
*34 Peritoneal Dialysis
|DIC_firmness=hard check
|DIC_timing=complete
|DIC_coding=query ''check_CCI_ICD10_Dialysis_no_Dx''
|DIC_implementation_date=2021-10-27
|DIC_status=implemented
|DIC_app=CCMDB.accdb
}}


== CRF/ARF vs [[TISS28]] items 32, 33, 34 ==
If a profile has one of the [[#Dialysis CCI Items]] there should also be one of the [[#Dialysis qualifying Dxs]].
=== Has ARF/CRF but not Dialysis ===
If meets following the entry is an error:
* ICU patient
* LOS>3
* at least one of dxs ([ARF (Diagnosis)]](350), [[CRF - Chronic Renal Failure]](351)
* '''doesn't have''' one of (T32/33/34) in TISS28


=== TISS implies dx ===
=== Dialysis CCI Items ===
If meets following the entry is an error:
*{{ CCIWithCode | CRRT (TISS Item)}}
* ICU patient
*{{ CCIWithCode | Peritoneal dialysis (TISS Item)}}
* LOS>3
*{{ CCIWithCode | Intermittent hemodialysis (TISS Item)}}
* at least one of (T33/34/35) in TISS28
*{{ CCIWithCode | PD (Peritoneal dialysis)}}
* '''doesn't have''' one of dxs ([ARF (Diagnosis)]](350), [[CRF - Chronic Renal Failure]](351), [[Acute Tubular Necrosis (ATN)]](352), [[Nephrotic Syndrome]](355), [[Hepatorenal Syndrome]](356), [[Pt Monitored while on Dialysis]] (398), ( a bunch of toxicities? eg [[TCA (Tricyclic)]] 450-499), [[Hyperkalemia K Greater Than 6.5]] (327), [[Rhabdomyolysis (Myoglobinemia)]] (357))  
*{{ CCIWithCode | HD (Hemodialysis)}}
*{{ CCIWithCode | CRRT (incl volume removal via PRISMA device)}}


== Reality check ==
=== Dialysis qualifying Dxs ===
{{discussion}}
*{{ICD10WithCode | Chronic kidney disease (chronic renal insufficiency, uremia) Stage 1, GFR GT 90}}
* Collectors can you see a scenario where this would not be an error? If not, this could be added to [[Change Priorities]]. Ttenbergen 20:17, 2014 April 30 (CDT){{Potential Change}}
*{{ICD10WithCode | Chronic kidney disease (chronic renal insufficiency, uremia) Stage 2, GFR 60-89}}
**codes 350 through 355 all pertain to ARF, however the other remaining codes are not correct, as they do not necessarily mean that dialysis is started [[User:Lkaita|Lisa Kaita]] 12:03, 2017 April 25 (CDT)
*{{ICD10WithCode | Chronic kidney disease (chronic renal insufficiency, uremia) Stage 3, GFR 30-59}}
*** So there are codes that ''might'' have dialysis, and codes that ''would'' have dialysis, right? I updated the two listings above. If pt has a dialysis-mandatory dx, must have TISS. If a pt has TISS, must have a dialysis-optional dx. Does the list of dxs in each case look right now? And, can you think of scenarios where these errors would lead to false positives? Ttenbergen 17:12, 2017 April 26 (CDT)
*{{ICD10WithCode | Chronic kidney disease (chronic renal insufficiency, uremia) Stage 4, GFR 15-29}}
*{{ICD10WithCode | Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15}}
*{{ICD10WithCode | Chronic kidney/renal disease, NOS (stage unspecified)}}
*{{ICD10WithCode | Kidney, renal failure/insufficiency/uremia, unspecified as acute or chronic}}
*{{ICD10WithCode | Kidney, acute renal failure, postprocedural}}
*{{ICD10WithCode | Kidney, acute renal failure NOS}}
*{{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:
** Aspirin & other salicylates -- {{ICD10WithCode | Aspirin or other salicylate or NSAID, overdose/toxicity}}
** Valproic acid, carbemazepine (Tegretol), phenytoin (Dilantin), barbiturates -- {{ICD10WithCode | Antiseizure drug NOS, overdose/toxicity}}
** Metformin -- {{ICD10WithCode | Insulin or other antidiabetes drug, overdose/toxicity}}
** Lithium -- {{ICD10WithCode | Psychiatric drug NOS, adverse effect}}
** Theophylline -- {{ICD10WithCode | Drug or biological substance/agent NOS, overdose/toxicity}}
** Alcohols --  
*** {{ICD10WithCode | Alcohol (ethanol), poisoning}}
*** {{ICD10WithCode | Toxic alcohols, poisoning}}
** Diltiazem -- {{ICD10WithCode | Calcium channel blocker, overdose/toxicity}}
** Occasionally a few others (rare)


== Short stay patients, incl community hospitals==
Allan confirmed that we would not need to add covid because if used in that context, renal failure would also be coded.
CRF/ARF patients may not receive dialysis if they are only there for a short time. That led to false=positives for the check, especially in community hospitals, so the restriction of "LOS>3" was added.  


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


[[Category: TISS28 Checks]]
[[Category:TISS28 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
  • Cargo


  • SMW


  • Categories: 
  • form:

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:
Retrieved from "https://ccmdb.kuality.ca/index.php?title=Query_check_CCI_ICD10_Dialysis_no_Dx&oldid=160441"