Query check ICD10 ESRD vs ARF

Data Integrity Checks
Summary:	Can't have ESRD and acute renal failure, except if there was a transplant during this ward stay
Related:	Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15, 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, Renal Coding Considerations for ICD10
Firmness:	hard check
Timing:	complete
App:	CCMDB.mdb
Coding:	query check_ICD10_ESRD_vs_ARF
Uses L Problem table:	not relevant for this app
Status:	needs review
Implementation Date:	2018/12/26
Backlogged:	true

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"CCMDB.mdb" is not in the list (CCMDB.accdb, Centralized data front end.accdb, TISS28.accdb, SAP, DSM Labs Consistency check.accdb, not entered) of allowed values for the "DICApp" property. 

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Implements the rules written out in Template:ICD10 Guideline ESRD vs Acute renal failure:

ESRD vs Acute Renal Failure

• Do NOT code both
  • Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15

AND

• Any of the acute renal failure diagnoses (Kidney, acute tubular necrosis (ATN), Kidney, acute renal failure NOS, Kidney, renal failure/insufficiency/uremia, unspecified as acute or chronic, Kidney, acute renal failure, postprocedural)

• UNLESS the patient has had a renal transplant and the transplanted kidney was functioning (and thus can experience acute renal failure)

About "Acute on Chronic renal failure"

• Our definition for CRF includes two things, as above. If you are on dialysis then it is technically not possible to also have acute renal failure. And while our threshold of creatinine clearance < 15 ml/min USUALLY gets people on dialysis, that's not always the case. In other words, there are some people who don't need to start dialysis until their clearance is <10 or even 8 ml/min. THOSE people who by our definition have Stage 5 CKD cannot have ARF but rather this is considered a progression of their underlying disease. Instead of coding ARF, code the reason for dialysis ie. Fluid overload, Hyperkalemia, severe or symptomatic etc combined with Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15

• And of course, if you previously had Stage 5, were on dialysis, then got a successful renal transplant, then you CAN get acute renal failure in your graft.

some of these give false positives for transplants, review what's up. I have heard nothing else about these false positives I think - are they still an issue? Ttenbergen 15:19, 2019 June 18 (CDT)

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Transplant patients

• Template:ICD10 Guideline Kidney transplant vs ESRD
• Query check ICD10 ESRD vs kidney transplant