HCC Best Practice: Chronic Kidney Disease

HCC Best Practice Advisory: Chronic Kidney Disease

To assist providers in identifying patients with potential Chronic Kidney Disease (HCC 136,137,138) diagnoses, the Clinical Documentation Excellence (CDE) team, in collaboration with clinical leaders, have created logic within the HCC Best Practice Advisory (BPA) tool. In this case, EPIC lab values are used to find potential diagnoses and present these within the BPA to clinicians. Within the EPIC “probable condition logic” hyperlink in the BPA, users will find information for all suspecting logic including that listed below:

HCC138 – CKD 3a

• Last GFR, within 12months, = 45-60.
• The next GFR, that was 3 months or greater since the last GFR, is less than 60.
• All GFRs between the last GFR and the GFR in line 2, will also be less than 60.

HCC 138 – CKD 3b

• Last GFR, within 12 months, = 30-44.
• The next GFR, that was 3 months or greater since the last GFR, is less than 60.
• All GFRs between the last GFR and the GFR in line 2, will also be less than 60

HCC 137 – CKD 4

• Last GFR, within 12 months, =16-29.
• The next GFR, that was 3 months or greater since the last GFR, is less than 60.
• All GFRs between the last GFR and the GFR in line 2, will also be less than 60.

HCC 136 – CKD 5

• Last GFR, within 12 months, <=15.
• The next GFR, that was 3 months or greater since the last GFR, is less than 60.
• All GFRs between the last GFR and the GFR in line 2, will also be less than 60.

A diagnosis of CKD5 will typically trigger an HCC Charge Correction in-basket message upon closure of the chart to clarify if the patient is on dialysis or not. If this should occur, simply respond as clinically appropriate.