AKI
Our coding staff will not code AKI unless it is spelled out as Acute Kidney Injury. They say we are getting denials because the term could be interpreted as Acute Kidney Insufficiency. They are asking us to query the MD to clarify the term. Has any one else run up against this? We feel that AKI is an acceptable acronym that stands for Acute Kidney Injury and that querying for it to be spelled out is redundant. Would love opinions.
Comments
https://www.tabers.com/tabersonline/
We initially ran into the same problem. Later discovered our organization uses Taber's as the standard for abbreviation documentation. We no longer have to query to have it spelled out.
Hope that helps!
This kind of denial actually makes me angry. AKI is a acronym known for Acute Kidney Injury. If the patient meets criteria to support AKI, how can a reviewer deny based on the fact that it could be interpreted as acute kidney insufficiency. The patient has FAILURE as supported by lab data and U/O. When our program started we thought we had a victory when we changed our docs from writing renal insufficiency to AKI. I would not badger our docs to write it out, fortunately we are almost all electronic now so it isn't an issue any longer.
If the pt meets criteria to support Acute Kidney Injury and AKI is written, and AKI is an acronym recognized by your hospital, then I would send a appeal letter after appeal letter (a form letter just like they send) to fight it. The Coding Clinics below also use AKI to mean Acute Kidney Injury.
Coding Clinic Coding Clinic 3Q 2011, p16 uses AKI meaning Acute Kidney Injury
Coding Clinic 4Q 2008, p192 spells out Acute Kidney Injury (AKI)
Coding Clinic 2Q 2011, p15 uses ARF meaning Acute Renal Failure
N17.9, Acute Kidney Injury, may be commonly coded at a site as the sole "CC'. The term "AKI", unless specifically noted and recognized by your organization, may be interpreted as Insufficiency or Injury, with different codes and impact on Billing.
Consider taking steps to define this abbreviation officially. Audit charts to ensure the term, when used, is clinically supported. I am going to venture a guess that at least sometimes the term AKI is charted, but only insufficiency rather than injury is present and supported as based on something used by your site, such as KDIGO.
Coders are 'correct' to be careful in the way this term is applied and coded.
Paul Evans, RHIA, CCDS, CCS. CCS-P
However, if one physician would write out "acute kidney insufficiency" and another would just write AKI; I would query the attending physician to clarify.