Renal Coding Considerations (old)

Data Integrity Rules

If CRF (351-00) is coded as comorbid then the following must not appear in Admit/Acquired codes

ARI (364-00)
ATN (352-00)
ARF (Diagnosis) (350 **) must not be coded as Admit/Acquired except if Renal Transplant (805 00) is also coded as a comorbid

These rules are currently checked at the main office and result in calls for clarification from Pagasa if broken.

I think we decided to get rid of the renal transplant part for this, right? If so, please remove... Ttenbergen 15:38, 25 November 2008 (CST)

So how do you check for patients with renal transplant in comorbid, done many years ago, but patient has been receiving outpatient dialysis for some time because of transplant failure prior to admission? TOstryzniuk 16:22, 8 October 2008 (CDT)
- We just check the data as part of the checks done as requested by Julie. Your question seems to relate more to how the data collectors should be getting that data. You have identified an important question that should be addressed as part of the article Renal Transplant. Should we move this thread there instead? Ttenbergen 14:21, 18 February 2009 (CST)

discussion Tina/Julie: If having more than 1 encounter (i.e.: continuous or same hospital admission), then Codes 350 and 351 should not appear together in at least one of the encounters. Why should they occur together in any? That happens and definitely that is encoding error. Ideally, should be all 350 in all encounters or all 351 in all encounters. Umm… ideally? So, flag it or not? Flag it
- Tina is correct, code is either 351 or 350 in all if continuous admission.TOstryzniuk 16:22, 8 October 2008 (CDT)
  - If I understand correctly that means that the current data integrity rule above takes care of this case already, since the special case was just eliminated, right? If so, this thread can be removed. Ttenbergen 15:32, 10 October 2008 (CDT)

If a patient is newly admitted to the hospital with ARF (350 00 first time dialysis ever) and moves between units (continuous admission) and he is still requiring dialysis , he remains as ARF (350 -00) until he is discharged from from the hospital.
- how would you know for sure that it was a first time dialysis ever? All we can know it's not a regular ongoing thing. Ttenbergen 15:32, 10 October 2008 (CDT)
- This instruction should go with the ARF article. And it is already there. So I think it should be removed from here. This article already refers to ARF for reference. It's not a good idea to spread the definitions over multiple pages since they will inevitably become inconsistent. I think this thread should be removed. Ttenbergen 15:32, 10 October 2008 (CDT)

If this same patient is readmitted back to the hospital from the community, and was on outpatient dialysis, then new encounter to the hospital system, comorbid code is not CRF (351 00). TOstryzniuk 16:22, 8 October 2008 (CDT)
- That information is implied in the instructions. Also, our data collectors would not necessarily know that a patient was ever admitted before, so they would not be able to do much about this. I think this thread should be removed. If you want to discuss further, I think it should be moved into CRF since it really relates to how CRF should be collected. This article was intended just to summarize the relationships between the conditions. Ttenbergen