CKD stages

tkreiling

I am just curious on when others query for CKD, do you query everytime you see CKD regardless of what the GFR is? I guess what I am asking is do you query even when it may only be a stage 1 or 2? Also, do you query for CKD stage when the pt has ARF? Thanks for any input others may have.

davisd2

Most the times our lab will not due the GFR they say it is not accurate for a pt over 60 (which is most of the patients I am working with for CMS). So when I query I look for an acute change from baseline, and I will give the MD's an estimated GFR and ask them to stage. But yes I query for Stage 1 and 2 because it gives us a baseline for the next admit for Acute on Chronic, which is most often the case.

davisd2

Most the times our lab will not due the GFR they say it is not accurate for a pt over 60 (which is most of the patients I am working with for CMS). So when I query I look for an acute change from baseline, and I will give the MD's an estimated GFR and ask them to stage. But yes I query for Stage 1 and 2 because it gives us a baseline for the next admit for Acute on Chronic, which is most often the case.


Denise Davis RN
Clinical Documentation Specialist
Quality Management
Sonora Regional Medical Center
1000 Greenley RD Sonora Ca 95370
209-536-3290
davisd2@ah.org

robert.hodges2

I concur Denise. The issue I look at is continuity of care vs. DRG impact.

Robert

Robert S. Hodges, BSN, MSN, RN
Clinical Documentation Improvement Specialist
Aleda E. Lutz VAMC
Mail Code 136
1500 Weiss Street
Saginaw MI 48602

dallend@einstein.edu

We only query for CKD if the GFR is < 30. That has to be patient's baseline either prior to admission or current baseline. We do not routinely query for CKD is the patient is in ARF - not all patients with ARF have CKD.
We have an average of 100 queries per person so we pick our battles.

pfowler

I query for stage when CKD is documented in the record by the MD to show
severity if illness and to obtain consistency with documentation.

Patsy Fowler RN, MSN, CCDS
Certified Clinical Documentation Specialist
Marion Regional Hospital
PO Box 1150
Marion, SC 29571
Office 843-431-2044
Cell 843-431-2863
Fax 843-431-2475

Unknown

I also query whenever CKD is documented. It's just a good habit to get the physicians into staging all CKD's.

NormaB

Same here. It is good to get them into the practice of staging CKD. Our Nephros are pretty awesome at documenting Stages. However they have the occasional "lapse in memory". I do focus more on those which are Stage IV especially if looking for CC/MCC's.

N. Brunson, RHIA, CCDS