AKI
After listening to the wonderful HCPro audioconference today that hightlighted the new changes regarding AKI as an MCC, I have the need to ask...
Does your facility accept AKI to mean Acute renal injury, Acute renal failure as one and the same. Seems there is a need to clarify the difference regarding function (AKI) and pathology (ARF), according to Dr Kennedy. That they are 2 separate conditions in the coding world. I know it will be a challenge to change physician habits as far as what is an easy thing to write, (AKI). And now we want them to specify the underlying condition that led to AKI and BTW...Don't write AKI anymore.
Any thoughts are appreciated.
Does your facility accept AKI to mean Acute renal injury, Acute renal failure as one and the same. Seems there is a need to clarify the difference regarding function (AKI) and pathology (ARF), according to Dr Kennedy. That they are 2 separate conditions in the coding world. I know it will be a challenge to change physician habits as far as what is an easy thing to write, (AKI). And now we want them to specify the underlying condition that led to AKI and BTW...Don't write AKI anymore.
Any thoughts are appreciated.
Comments
Robert
Robert S. Hodges, BSN, MSN, RN
Clinical Documentation Improvement Specialist
Aleda E. Lutz VAMC
Mail Code 136
1500 Weiss Street
Saginaw MI 48602
P: 989-497-2500 x13101
F: 989-321-4912
E: Robert.Hodges2@va.gov
We have discussed this with our renal docs - at our facility AKI and ARF are synonymous - it is even listed on our abbreviation list.
The only time we query to clarify is if someone (we have one PA) documents acute kidney insufficiency and then AKI.
condition and normally acute. If they document it as chronic I ask them
to clarify it according to National Kidney Foundation guidelines. But
then I'm a little obsessive compulsive too.
Robert
Robert S. Hodges, BSN, MSN, RN
Clinical Documentation Improvement Specialist
Aleda E. Lutz VAMC
Mail Code 136
1500 Weiss Street
Saginaw MI 48602
P: 989-497-2500 x13101
F: 989-321-4912
E: Robert.Hodges2@va.gov
"The difference between the right word and the almost right word is the
difference between lightning and the lightning bug." Samuel "Mark Twain"
Clemens. The difference is the Lord not Mark Twain.
-
AKI and ARF, unspecified have the same code - 584.9, which is a CC as we all know.
The only renal failure conditions that qualify for MCC status are the following:
Renal failure (OR AKI) due to or associated with:
- ATN
- medullary necrosis
- cortical necrosis
- with other specified pathological lesion
Also note that we need to get both components - the ARF or AKI plus the etiology (listed above) to get the right code.
It should be considered standard practice to always ask what the cause of the ARF/AKI is. That way we're delivering a consistent message to the providers and can't be accused of only querying when it results in a higher-weighted DRG.
I also did a blog post that talked about ATN you may find useful:
http://blogs.hcpro.com/acdis/2010/12/resources-to-help-cdi-with-atn-confusion/
Don
Thanks,
Sharon
We don’t, or I wouldn’t recommend it at least. It needs to be spelled out as it could be acute kidney injury or acute kidney insufficiency.
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
-----Original Message-----
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Friday, January 17, 2014 2:46 PM
To: Kathryn Good
Subject: [cdi_talk] AKI
Some controversy here:
HOW do you code the ABBREVIATION "AKI"???
Any responses appreciated.
Paul Evans, RHIA, CCDS
---
CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.
You are receiving this message as a member of CDI Talk as: kathryn.good@nahealth.com If you would like to be removed from CDI Talk, please send a blank email to leave-cdi_talk-12649561.a6bbaf3538c19e934e5136fbd051a6b1@hcprotalk.com
---
Copyright 2013
HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
Yes - one should check Bun, Cr, GFR, so forth - however, coding from only an abbreviation has some risks...
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.637.9002
Fax: 415.600.1325
Ofc: 415.600.3739
evanspx@sutterhealth.org
http://forums.hcpro.com/forum/messageview.cfm?catid=14&threadid=9974
A previous place I worked viewed it like this: AKI means acute kidney injury UNLESS someone states insufficiency as well- then it should be queried for clarification.
Ann Donnelly,RN,BSN,CCDS
On Jan 17, 2014, at 5:05 PM, CDI Talk wrote:
> I'm with you Paul ;-)
>
> Katy Good, RN, BSN, CCDS, CCS
> Clinical Documentation Program Coordinator
> AHIMA Approved ICD-10CM/PCS Trainer
> Flagstaff Medical Center
> Kathryn.Good@nahealth.com
> Cell: 928.814.9404
>
>
> -----Original Message-----
> From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
> Sent: Friday, January 17, 2014 2:55 PM
> To: Kathryn Good
> Subject: RE: [cdi_talk] AKI
>
> AKI is an abbreviation with multiple meanings...IMO, the term requires a query. However, my coding mgr is adamant this codes to 584.9 and no query is required. I disagree, but welcome opinions.
>
> Yes - one should check Bun, Cr, GFR, so forth - however, coding from only an abbreviation has some risks...
>
> Paul Evans, RHIA, CCS, CCS-P, CCDS
>
> Manager, Regional Clinical Documentation & Coding Integrity Sutter West Bay
> 633 Folsom St., 7th Floor, Office 7-044 San Francisco, CA 94107
> Cell: 415.637.9002
> Fax: 415.600.1325
> Ofc: 415.600.3739
> evanspx@sutterhealth.org
>
>
>
>
> -----Original Message-----
> From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
> Sent: Friday, January 17, 2014 03:50 PM
> To: Evans, Paul
> Subject: RE: [cdi_talk] AKI
>
> Ha! Good question Paul.
> We don
Linda Haynes, RHIT, CCDS
Manager, CDI
Legacy Health
lhaynes@lhs.org
I would code the AKI as 584.9 because of the C.Clinic -3rd Qrtr. 2011- AKI, diabetic Nephropahty and CKD, stage III clarification. The 2nd paragraph under the answer documents: "The correct coding is code 584.9, Acute renal failure , unspecified , for the diagnosis of AKI. With AKI included on your approved Med. Staff abbreviation list, I think you are covered in coding AKI to 584.9. Of course, clinical indicators should always be met.
Jolene File,RHIT,CCS,CPC-H,CCDS
Documentation Improvement Specialist-Coder
Hays Medical Center
jolene.file@haysmed.com
Thanks,
-Jane
p 303-603-9581
c 303-249-3521
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421
evanspx@sutterhealth.org
[cid:image001.jpg@01D105B0.28790DA0]
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Tuesday, October 13, 2015 12:02 PM
To: Evans, Paul
Subject: [cdi_talk] AKI
Humana states that the KDIGO criteria can only be applied once patient is euvolemic such that creatinine is not continuing to actively decrease on IV fluids or oral rehydration thus negating typical pre renal causes of creatinine elevation.
Theresa Crosslin RN CM
Cookeville Regional Medical Center
931-783-2078
TCrosslin@crmchealth.org
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Tuesday, October 13, 2015 2:11 PM
To: Theresa Crosslin
Subject: RE:[cdi_talk] AKI
I am not a Nephrologist, but those are huge changes in Cr….Are you using current KDIGO criteria? Pertinent question would be how the changes in Cr day-to-day. I’d cite the KDIGO criteria in any rebuttal. I assume you have that criteria.
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421
evanspx@sutterhealth.org
[cid:image001.jpg@01D105C2.DD66A120]
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Tuesday, October 13, 2015 12:02 PM
To: Evans, Paul
Subject: [cdi_talk] AKI
We are seeing coding denials from Humana for Acute Renal Failure. The rational they are giving is that the diagnosis of Acute Kidney Failure will only be considered after achieving an adequate status of hydration and after excluding urinary obstruction. Also criteria for Acute Kidney Failure will not apply if patient is on diuretic.
On admission the BUN was 78, Cr 4.6, Na 124 This did improve with IV fluid.
Day of D/C Cr 0.8, BUN 12
So I wondering if others are seeing this type of denial and if so what are you doing about it?
Theresa Crosslin RN CM
Cookeville Regional Medical Center
931-783-2078
TCrosslin@crmchealth.org
---
CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.
You are receiving this message as a member of CDI Talk as: evanspx@sutterhealth.org
If you would like to be removed from CDI Talk, please send a blank email to
leave-cdi_talk-12940161.4b24e9352adc7dfa247d8332246d4e2a@hcprotalk.com
---
Copyright 2013
HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
---
CDI Talk is offered for networking purposes. For official rules and regulations related to documentation and coding, please refer to your regulatory source.
You are receiving this message as a member of CDI Talk as: TCrosslin@crmchealth.org
If you would like to be removed from CDI Talk, please send a blank email to
leave-cdi_talk-20192183.5dfc436b24205ed7cd7fec3ed5448af9@hcprotalk.com
---
Copyright 2013
HCPro, Inc., 75 Sylvan Street, Danvers MA 01923
This email message has been delivered safely and archived online by Mimecast. For more information please visit http://www.mimecast.com
Content-Type: multipart/related;
boundary="_005_ABA1EC7D17D936429E668496F8D0927F018AB7B3MSXMBXNSPRD33ac_";
type="multipart/alternative"
--_005_ABA1EC7D17D936429E668496F8D0927F018AB7B3MSXMBXNSPRD33ac_
Content-Type: multipart/alternative;
boundary="_000_ABA1EC7D17D936429E668496F8D0927F018AB7B3MSXMBXNSPRD33ac_"
--_000_ABA1EC7D17D936429E668496F8D0927F018AB7B3MSXMBXNSPRD33ac_
Content-Type: text/plain; charset="utf-8"
Content-Transfer-Encoding: base64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--_000_ABA1EC7D17D936429E668496F8D0927F018AB7B3MSXMBXNSPRD33ac_
Content-Type: text/html; charset="utf-8"
Content-Transfer-Encoding: base64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--_000_ABA1EC7D17D936429E668496F8D0927F018AB7B3MSXMBXNSPRD33ac_--
--_005_ABA1EC7D17D936429E668496F8D0927F018AB7B3MSXMBXNSPRD33ac_
Content-Type: image/jpeg; name="image001.jpg"
Content-Description: image001.jpg
Content-Disposition: inline; filename="image001.jpg"; size=2505;
creation-date="Tue, 13 Oct 2015 19:34:13 GMT";
modification-date="Tue, 13 Oct 2015 19:34:13 GMT"
Content-ID:
Content-Transfer-Encoding: base64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--_005_ABA1EC7D17D936429E668496F8D0927F018AB7B3MSXMBXNSPRD33ac_--
--_006_ABA1EC7D17D936429E668496F8D0927F018AB7B3MSXMBXNSPRD33ac_
Content-Type: application/vnd.openxmlformats-officedocument.wordprocessingml.document;
name="Definition of acute kidney injury.docx"
Content-Description: Definition of acute kidney injury.docx
Content-Disposition: attachment;
filename="Definition of acute kidney injury.docx"; size=24549;
creation-date="Tue, 13 Oct 2015 19:28:00 GMT";
modification-date="Tue, 13 Oct 2015 19:28:01 GMT"
Content-Transfer-Encoding: base64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--_006_ABA1EC7D17D936429E668496F8D0927F018AB7B3MSXMBXNSPRD33ac_--
Kim Williams, RN
Clinical Documentation Specialist
Revenue Management Department
(252) 535-8154
(252) 535-8937 fax
[cid:image002.jpg@01D105D4.4F8559C0]
From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Tuesday, October 13, 2015 3:34 PM
To: Williams, Kim
Subject: RE:[cdi_talk] AKI
I’d be interested to see how others in our profession feel, particularly someone that may have experience taking care of CRF patients on dialysis unit, or with strong background in renal topics.
It would be helpful to cite the step-wise change in Cr from day to day – everything I have been taught about ARF supports the condition when the abrupt changes cited in KDIGO occur.
I don’t find the exclusions that Humana is citing either, but I have not taken time to read the KDIGO before I reply today –
To my knowledge, 3 main forms of ARF have been recognized for decades
· Pre
· Renal
· Post
The fact a pt may indeed have a pre-renal form of ARF does not mean the condition is present or supported IMO. But, again, I am not an MD.
Paul
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421
The fact a pt may indeed have a pre-renal form of ARF does not mean the condition is NOT present or supported IMO. But, again, I am not an MD.
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421
evanspx@sutterhealth.org
My advice- appeal and use evidence. I believe they count on organizations throwing in the towel and in that case, it is an easy win for them.
Good luck!
Kerry
Kerry Seekircher, RN, BS, CCDS, CDIP
Clinical Documentation Program Manager
Northern Westchester Hospital
400 East Main Street
Mount Kisco, NY 10549
Email: kseekircher@nwhc.net
Phone: 914-666-1243
Fax: 914-666-1013
Colleagues: I urge us all to appeal IF the denial does not seem valid…many of you have shared ‘reasons’ for denials from 3rd parties that are nothing more than fishing expeditions. If the denial is valid, so be it, learn and go on. But, if not, consider an appeal.
[cid:image002.png@01D105C3.03797C70]
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421
evanspx@sutterhealth.org
[cid:image001.jpg@01D105C2.974634D0]
I appeal almost every time and they just continue to deny. One huge problem for us with Humana is that they are their own judge, jury and executioner, so the same people who originally denied are the ones who handle the appeal. And they just repeat the same tired arguments without even addressing anything I’ve said. I think their function is to exhaust us into submission.
Renee
Linda Renee Brown, RN, MA, CCDS, CCS, CDIP
Director, Clinical Documentation
Tanner Health System
Has anyone spoken to a nephrologist (or Dr. Pinson for that matter) regarding this?
Thanks,
-Jane
p 303-603-9581
c 303-249-3521
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421
evanspx@sutterhealth.org
Paul
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421
evanspx@sutterhealth.org
[cid:image001.jpg@01D1065C.75326590]
Kathy
Kathleen Benson RN, BSN, CCDS
Supervisor, Clinical Documentation Integrity
UWHealth University of Wisconsin Hospital
Office Location: University Crossing, 749 University Row, Suite 200
Mailing Location: 600 Highland Avenue, Mail Code 9920
Madison, WI 53792-9475
608-516-5638
kbenson@uwhealth.org
[cid:image002.png@01D10671.9AE33E30]
Kathleen Benson RN, BSN, CCDS
Supervisor, Clinical Documentation Integrity
UWHealth University of Wisconsin Hospital
Office Location: University Crossing, 749 University Row, Suite 200
Mailing Location: 600 Highland Avenue, Mail Code 9920
Madison, WI 53792-9475
608-516-5638
kbenson@uwhealth.org
[cid:image003.png@01D1067C.55AABFE0]
When they are this far off course, they should be challenged. It is pertinent to note the some of the RAC audit firms have lost contracts because the audit findings were flawed.
PE
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421
evanspx@sutterhealth.org
I did find in Up-To-Date where AKIN had proposed that “The dx criteria should be applied only after volume status has been optimized”
But in the modifications to the RIFLE and AKIN made by KDIGO makes no mention of this so did they remove this when they proposed their definition of Acute Renal Failure?
Sorry I don’t mean to beat this to death but the coder has done I appeal and it has been denied and we have several other cases.
Theresa Crosslin RN CM
Cookeville Regional Medical Center
931-783-2078
TCrosslin@crmchealth.org
Kim Williams, RN
Clinical Documentation Specialist
Revenue Management Department
(252) 535-8154
(252) 535-8937 fax
[cid:image004.jpg@01D10694.60A13880]