inaccurate mapping of End-stage renal disease (ESRD) HCPCS codes

[dimshitc]

Please see attached wrong_HCPCS_Dialysis_mapping.xlsx

these codes don't say about the 8949 End-Stage Renal Disease Treatment Facility some of them explicitly say 'home dialysis'.

Also this mapping makes creation of dialysis patients cohort harder. The meaning of these concepts is that patient got specific services, but not visited the facility

Maybe we get rid of these mappings to Visits overall? it complicates the ETL logic and complicates research

@cgreich

[TinyRickC137]

Hi, @dimshitc

The procedure of 'home dialysis' could not be carried out without medical support for prolonged periods. These codes mean that patients received ESRD care, provided in certified facilities. Please check out this article on how the related CPT codes are used.

The decision on mapping CPT/HCPCS code was made quite a long time ago and has been discussed numerous times after that. The current state is a compromise to a) cover use-cases with visits available from other data sources and b) cover use-cases with visits, constructed from HCPCS/CPT.

If you think that this should be redone again, we can discuss it. Besides, I don't see how these mappings make the creation of a dialysis cohort harder and how removing them will solve a problem.

[dimshitc]

Thanks @TinyRickC137 for this comprehensive answer

while 8949 End-Stage Renal Disease Treatment Facility Is an Outpatient visit.

[dimshitc]

I really like the idea of grouping these END STAGE RENAL DISEASE (ESRD) RELATED SERVICES concepts under one target concept, which makes creation of cohort much easier on a practice. But the conflicts between visit types prevents the ETL of doing that. Would be nice instead of mapping, to have hierarchical relationship that will cover all these ESRD services, so it would be easy to create a concept set, I believe it should be an Observation domain. Please see general problem analysis and proposed solution here