Renal Failure
As a new member to this forum I have seen a few older posts regarding renal failure. I think that the issue is being shishkabobbed by payers and RAC auditors only using the AKI and RIFLE criteria while others such as Am Thoracic Society use a lesser definition that impairs and injures some urban academic centers with higher rates of renal failure that would not qualify as renal failure. Medicine is an inexact science. There will be ambiguity. We all deal with it. I attempted to attach a fle that Iuse to discuss this. I believe that these can help in appeals as well as help your teams decide on what should be documented. Since my file is too big I am sending the best parts.
Issues Revolving Around Renal Failure
The definition of acute renal failure and chronic renal failure have been changing.
Unfortunately multiple bodies and colleges are using new and old definitions in there work products.
Society of Thoracic Surgeons uses an arbitrary number that few organizations agree with.
NKF/KDOQI have strived to create a patho-physiologic definition to create awareness of early recognition and intervention.
Diagnostic criteria for AKI : An abrupt (within 48 hours) reduction in kidney function currently defined as an absolute increase in serum creatinine of > 0.3 mg/dl ( > 25 micromole/L), a percentage increase of 50% or a reduction in urine output (documented oliguria of < 0.5 ml/kg/hr for > 6 hours) http://www.kidney.org/news/newsroom/newsitem.cfm?id=43&&cid=20
Acute renal failure: definitions, diagnosis, pathogenesis, and therapy
Robert W. Schrier, Wei Wang, Brian Poole, and Amit Mitra; J Clin Invest. 2004 July 1; 114(1): 5–14
This article from 2004 can help with RAC and Payers who deny ARF.
Good Luck,
Jon
Issues Revolving Around Renal Failure
The definition of acute renal failure and chronic renal failure have been changing.
Unfortunately multiple bodies and colleges are using new and old definitions in there work products.
Society of Thoracic Surgeons uses an arbitrary number that few organizations agree with.
NKF/KDOQI have strived to create a patho-physiologic definition to create awareness of early recognition and intervention.
Diagnostic criteria for AKI : An abrupt (within 48 hours) reduction in kidney function currently defined as an absolute increase in serum creatinine of > 0.3 mg/dl ( > 25 micromole/L), a percentage increase of 50% or a reduction in urine output (documented oliguria of < 0.5 ml/kg/hr for > 6 hours) http://www.kidney.org/news/newsroom/newsitem.cfm?id=43&&cid=20
Acute renal failure: definitions, diagnosis, pathogenesis, and therapy
Robert W. Schrier, Wei Wang, Brian Poole, and Amit Mitra; J Clin Invest. 2004 July 1; 114(1): 5–14
This article from 2004 can help with RAC and Payers who deny ARF.
Good Luck,
Jon