Renal Transplant

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This page is about the pre-ICD10 diagnosis coding schema. See the ICD10 Diagnosis List, or the following for similar diagnoses in ICD10:

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Category/Organ System:	Category: Renal (old)
Type:	Medical Problem
Main Diagnosis:	Renal Transplant Surgery
Sub Diagnosis:	00 - RENAL TRANSPLANT SURGERY 01 - Removal of Transplant-Organ 02 - Failed 03 - Rejection 04 - Cadaver Donor 05 - Living Donor
Diagnosis Code:	805-**
Comorbid Diagnosis:
Charlson Comorbid coding (pre ICD10):
Program:	Critical Care and Medicine
Status:	Currently Collected

Coding during the admission where transplant occurs

Renal Transplant Patient coding process

• Patient Type (Registry): Surgical
• Apache Type: Elective Surgery
• Admit DX: Pre-op Optimization - 893
• Complication is only one of:
  • Renal Transplant – living donor – 805-04
  • Renal Transplant – Cadaver donor 805-05

Discussion

• Is the complication for organ source mandatory? Should there be a check for it? Ttenbergen 16:56, 3 September 2009 (CDT)
• Where does the transplant itself get coded then? These instructions omit it.Ttenbergen 16:57, 3 September 2009 (CDT)
• Just to confirm - is the transplant surgery truly elective at all times? Would there not be an "expiry" consideration for cadaver donors? Ttenbergen 16:59, 3 September 2009 (CDT)

Renal Donor Coding Process

see Nephrectomy

Coding during future admissions of Renal Transplant Recipients

Intact and working transplant

• do not code CRF if the patient's transplant is working

Transplant not working

• if transplant is not working and patient meets coding requirement, code CRF
• enter Renal Transplant in comorbids
• enter one of the following codes as admit or complication as appropriate, prioritizing is as usual:
  • Renal Transplant Surgery - Rejection (361-01)
  • Renal Transplant Surgery - Other (361-90) if not clearly related to rejection

Considerations for entering Tasks

Renal Transplant patients sometimes qualify for one of the Dialysis Tasks either prior to transplant of if an earlier transplant has failed; check that article and code the task if applicable.

• Renal Transplant patients who are on peritoneal dialysis are 99% of the time are given chronic peritoneal dialysis prior to surgery. Following their Renal Transplant they may have delay of graft function, as a complication,and require acute peritoneal dialysis. In this case, I can only capture one task: chronic or acute. Because the acute event is more Relevant, I have been capturing only the acute peritoneal dialysis.

Is it clear, that pts with CRF as a comorbidity, who have a Renal Transplant, will usually not require dialysis for their remainder of hospital stay.--FLindell 15:14, 14 September 2009 (CDT)--FLindell 15:14, 14 September 2009 (CDT)

Data Integrity Rules

Template:Data Integrity Rules There are a number of coding rules related to renal diagnoses, centralized info about them is in Renal Coding Considerations.

Related Articles

see Category:Renal Problem for other renal problems