Query check CCI ICD10 Dialysis no Dx
If there is a TISS28 entry for Hemodialysis there should be a corresponding Dx.
- Intermittent hemodialysis (TISS Item) (T32)
- CRRT (TISS Item) (T33)
- Peritoneal dialysis (TISS Item) (T34)
CRF/ARF vs TISS28 items 32, 33, 34
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
If meets following the entry is an error:
- ICU patient
- LOS>3
- at least one of (T32/33/34) in TISS28
- doesn't have one of dxs ([ARF (Diagnosis)]](350), CRF - Chronic Renal Failure(351), Pt Monitored while on Dialysis (398),
Reality check
- 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)Template:Potential Change
- 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 Lisa Kaita 12:03, 2017 April 25 (CDT)
- 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)
- Sorry T I misread the diagnostic codes, was looking at subcodes of 350, so I updated the above. 350 ARF always has dialysis, 351 CRF comorbid (chronic dialysis)could potentially create a false positive if a patient is admitted and dies before every receiving dialysis, this does not happen very often, but the potential is there. All other codes "might" have dialysis but would usually be coded in addition to 350 if they are being dialyzed.Lisa Kaita 10:11, 2017 April 27 (CDT)
- I could add restrictions to reduce false positives but maybe not trap odd cases. Can you think of a reasonable restriction? In Check CRF/ARF against TISS Dialysis we were saying "LOS > 3days; I could add some death concept to the restrictions if we can think of them. Actually, is there any reason the two checks would NOT use essentially the same combination of criteria for Tasks (med) vs TISS (icu)? It might even end up being the same check... if the dx + criteria are right, must have either task or TISS?Ttenbergen 15:54, 2017 April 27 (CDT)
- Sorry T I misread the diagnostic codes, was looking at subcodes of 350, so I updated the above. 350 ARF always has dialysis, 351 CRF comorbid (chronic dialysis)could potentially create a false positive if a patient is admitted and dies before every receiving dialysis, this does not happen very often, but the potential is there. All other codes "might" have dialysis but would usually be coded in addition to 350 if they are being dialyzed.Lisa Kaita 10:11, 2017 April 27 (CDT)
- 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)
- 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 Lisa Kaita 12:03, 2017 April 25 (CDT)
- I don't know if any of this is actually implemented. At this point it should probably wait for CCI/ICD10.
- ICD10: Renal dialysis care, including dialysis itself
- CCI: ???
Template:ICD10Template:CCI See also Renal Coding Considerations for ICD10.
Short stay patients, incl community hospitals
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.
Template:Data Integrity Checks
Not yet implemented.