Renal Coding Considerations (old)

There are a few restrictions about which renal diagnoses can be coded together. These checks are currently done partly by Pagasa (!_Automated_Data_Integrity_Checks#CRF_vs_ARF) and have been partly implemented in CCMDB.mdb.

Data Integrity Rules that can be checked before sending

These rules are currently checked at the main office and result in calls for clarification from Pagasa if broken. Some of them have been added to CCMDB.mdb, more are to follow.

Competing Diagnoses

• If no Renal Transplant (80504 or 80505) in either Dxs or Comos then
  • If comorbid CRF (351-00) exists then the following must not appear in Admit/Acquired codes
    • ARI (364-00)
    • ATN (352-00)
    • ARF (Diagnosis) (350 **)

Implementation

Implementing in CCMDB.mdb as Check Renal IncompatibleDxs.

Diagnoses, Comos vs. Tasks, locations

• see Check_Renal_Tasks

Discussion

• see Check_Renal_Tasks#Discussion

Apache vs. CRF comorbid

• see Check ApARF CRF.

Apache vs. ARF Dx

cross-checks impossible due to different definitions, see ARF (Diagnosis) and ARF (APACHE)

Data Integrity Rules that can not be checked before sending

ARF and ICU TISS

• TISS 53 to 55: Don't forget to cross check the TISS form with the diagnosis and visa versa.

ARF & TISS integrity checks

• have TISS 53, 54, 55 but no Renal failure DX (350, 351, 352, 355, 356, 398, 450-499, 327, 357)
• from community hosp to teaching hosp with DX of 350 AND no dialysis on TISS at community hosp AND DX of 350 AND TISS 53, 54 or 55 marked at teaching hospital, then the DX of ARF for community hospital is correct.

(This integrity check is for Julie only for her SASS program) See comment for data collectors:

ARF transfer considerations

• • When a pt starts out in a community hospital and is given a diagnosis of ARF by the doctors, please do not code ARF unless dialysis is started there. Code ATN or ARI instead. If the pt is transferred to another center to start dialysis, the collector there will code ARF. When a pt with ARF from a tertiary hospital is transferred to a community hospital and no dialysis is needed there, the data collectors at the community hospital should not be coding ARF because the renal failure is resolving. They can code ARI. This is my understanding. Trish please let me know if this is the way you also see it. I believe the above information for integrity checks is wrong. --LKolesar 13:41, 20 July 2011 (CDT)

Template:Discussion Are you talking about the ARF checkbox in Apache or the DX? Ttenbergen 14:45, 21 July 2011 (CDT)

Related Articles

see Category:Renal Problem for other renal problems