Renal conditions support a skilled Part A day in several scenarios: recovery from acute kidney injury, management of chronic kidney disease and end-stage renal disease, coordination of dialysis and care of the dialysis access, and the fluid and electrolyte management that renal impairment requires. The skilled element is the renal observation — tracking intake and output and weight, monitoring electrolytes and volume status, and protecting and assessing the dialysis access — because a renal or fluid-electrolyte change can be rapid and dangerous.
The purpose of this module is to prove, for each billed day, that skilled renal observation, a covered procedure, teaching, or management of the plan was reasonable, necessary, needed daily, and available only in a SNF under Pub. 100-02 Chapter 8. The renal content is the same as in home care; the coverage spine is re-pointed. Catheter and UTI care are authored in the Continence reference; dialysis specifics route to the Dialysis overlay.
