P41 KE-P41 · outpatient visit

One row per condition family: what the record supports under the published definition, what the note states, the visit's diagnosis entries, and an assessment. Codes are coded from the signed documentation; the software never assigns one.

Note: unsigned draft

Side-panel conditions check FRUN-00049 · front-engine 1.2 · replay 7a95e4723ad721c6…

Library check LRUN-00049 · library_default_set@1.1 · library-engine 1.1 · replay afbc530234833473… · Data (JSON)

Core definitions 2

Core definitions: condition families for this encounter (2)
Condition family	What the record supports	What the note states	Visit diagnosis entries	Assessment
Heart failure type (ejection fraction) judgement tier · side-panel condition	`front_hf_ef_type@1.0` Draft · pending review Record meets: Heart failure with reduced ejection fraction (HFrEF) Ejection fraction 30% · echocardiogram 2026-10-19 (transthoracic, report text only): Left ventricular ejection fraction is 30% by biplane method. (Dr. Ines Varga (cardiology)) · ECHO-P41-1 read from the report text by the AI reader · quote verified · rule reader agrees Options and what the record shows Heart failure with reduced ejection fraction (HFrEF) · needs latest ejection fraction 40% or lower · record: latest 30% on 2026-10-19 · met Heart failure with mildly reduced ejection fraction (HFmrEF) · needs latest ejection fraction 41% to 49% · record: latest 30% on 2026-10-19 · not met Heart failure with preserved ejection fraction (HFpEF) · needs latest ejection fraction 50% or higher · record: latest 30% on 2026-10-19 · not met Heart failure with improved ejection fraction (HFimpEF) · needs an earlier ejection fraction of 40% or lower, the latest above 40%, and a rise of at least 10 points · record: only one measurement on file (30% on 2026-10-19) · not assessable Citation Heart failure type by ejection fraction (four categories, 2021 universal definition as restated in 2022) front_hf_ef_type@1.0 In our words: Reduced ejection fraction: 40% or lower. Mildly reduced: 41% to 49%. Preserved: 50% or higher. Improved: an earlier ejection fraction of 40% or lower, a later one above 40%, and a rise of at least 10 points. (2021 edition, as restated in an openly licensed 2022 paper.) HFrEF, LVEF ≤ 40% Chandramouli C, Stewart S, Almahmeed W, Lam CSP (Clinical Cardiology), Clinical implications of the universal definition for the prevention and treatment of heart failure (2022) · Section 1.3 'New universal definition' (classification by left ventricular ejection fraction) · source Licence: open licence: CC BY 4.0, attribution: Chandramouli C, Stewart S, Almahmeed W, Lam CSP. Clinical implications of the universal definition for the prevention and treatment of heart failure. Clin Cardiol 2022;45(Suppl 1):S2-S12. doi:10.1002/clc.23842. Licensed under CC BY 4.0.. Source checked: opened. No endorsement by the cited bodies is implied. To confirm with a clinician: the boundary wording at exactly 40%. This file reads reduced as 40% or lower (the openly licensed source); the federal cross-check says below 40%. A reported 40% is shown as reduced. To confirm with a clinician: the improved-category baseline rule. The baseline is the first earlier ejection fraction of 40% or lower on file and the comparison value is the latest; another reading (lowest earlier value, or the value just before the latest) can give a different answer. To confirm with a clinician: whether the 2021 categories should stay the shown edition now that a 2026 edition reportedly drops fixed cut-offs between reduced and preserved.	CHF	None entered	Supported, but entered or stated less specifically than the record supports The note says “CHF”; the record has an ejection fraction of 30% on 2026-10-19. The note does not state the type. Clinician's response to the side-panel card: No response yet · offer OF-000043 Draft a query
Whole code category, for reference (no code is selected, ranked or suggested): Heart failure type (ejection fraction) Coders only reference for coders — the clinician's documented statement governs; the software does not assign codes `I50` Heart failure (23 codes in the category). `I50.1` Left ventricular failure, unspecified `I50.20` Unspecified systolic (congestive) heart failure `I50.21` Acute systolic (congestive) heart failure `I50.22` Chronic systolic (congestive) heart failure `I50.23` Acute on chronic systolic (congestive) heart failure `I50.30` Unspecified diastolic (congestive) heart failure `I50.31` Acute diastolic (congestive) heart failure `I50.32` Chronic diastolic (congestive) heart failure `I50.33` Acute on chronic diastolic (congestive) heart failure `I50.40` Unspecified combined systolic (congestive) and diastolic (congestive) heart failure `I50.41` Acute combined systolic (congestive) and diastolic (congestive) heart failure `I50.42` Chronic combined systolic (congestive) and diastolic (congestive) heart failure `I50.43` Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure `I50.810` Right heart failure, unspecified `I50.811` Acute right heart failure `I50.812` Chronic right heart failure `I50.813` Acute on chronic right heart failure `I50.814` Right heart failure due to left heart failure `I50.82` Biventricular heart failure `I50.83` High output heart failure `I50.84` End stage heart failure `I50.89` Other heart failure `I50.9` Heart failure, unspecified Source: official ICD-10-CM FY2027 code descriptions (extract in library/data/code_reference_fy2027.json).
Kidney disease stage (filtering rate) measured · side-panel condition	`front_kidney_stage_wording@1.0` Draft · pending review No wording's requirement is met by the record Options and what the record shows Chronic kidney disease stage 1 · needs filtering rate 90 or above with a kidney damage marker (for example albuminuria on two tests at least 90 days apart) · record: filtering rate 60 or above; needs a kidney damage marker (no persistent albuminuria on file) · not assessable Chronic kidney disease stage 2 · needs filtering rate 60-89 with a kidney damage marker (for example albuminuria on two tests at least 90 days apart) · record: filtering rate 60 or above; needs a kidney damage marker (no persistent albuminuria on file) · not assessable Chronic kidney disease stage 3a · needs filtering rate 45-59 on two results at least 90 days apart · record: results at least 90 days apart are 60 or above · not met Chronic kidney disease stage 3b · needs filtering rate 30-44 on two results at least 90 days apart · record: results at least 90 days apart are 60 or above · not met Chronic kidney disease stage 4 · needs filtering rate 15-29 on two results at least 90 days apart · record: results at least 90 days apart are 60 or above · not met Chronic kidney disease stage 5 · needs filtering rate below 15 on two results at least 90 days apart · record: results at least 90 days apart are 60 or above · not met Citation Kidney disease stage wording by filtering rate, with the albumin-to-creatinine category (options for the clinician) front_kidney_stage_wording@1.0 In our words: Kidney disease by filtering rate: below 60 on results at least 3 months apart; or urine albumin-to-creatinine ratio 30 mg/g or higher on two tests at least 3 months apart. Stage by filtering rate: G1 90 or above; G2 60-89; G3a 45-59; G3b 30-44; G4 15-29; G5 below 15 (G1 and G2 also need a marker of kidney damage). Albumin-to-creatinine category: A1 below 30, A2 30-299, A3 300 mg/g or above. The filtering rate is estimated with the 2021 race-free creatinine equation. Decreased eGFR <60 mL/min/1.73 m2 (GFR categories G3a-G5) for ≥3 months Department of Veterans Affairs and Department of Defense, VA/DoD Clinical Practice Guideline for the Primary Care Management of Chronic Kidney Disease, Provider Summary (Version 5.0) (2025) · Sidebar 6 'Criteria for CKD' (PDF page 16; printed page 13 of 37). Do not use Sidebar 9 (a reproduced third-party figure) · source Licence: U.S. government work (public domain); filtering-rate stage bands (90, 60, 45, 30, 15) and the G3a/G3b split: fact only citation; albumin-to-creatinine categories (A1 below 30, A2 30-299, A3 300 mg/g or above): fact only citation; 2021 creatinine equation: public domain. Source checked: opened. No endorsement by the cited bodies is implied. To confirm with a clinician: three months is encoded as 90 days (the VA/DoD summary says 3 months or more).	Not stated	None entered	Nothing to act on Kidney results 200 days apart are 60 or above (filtering rate 86.6 on 2026-04-26 and 86.6 on 2026-11-12) and the note doesn't mention kidney function. Clinician's response to the side-panel card: No response yet
Whole code category, for reference (no code is selected, ranked or suggested): Kidney disease stage (filtering rate) Coders only reference for coders — the clinician's documented statement governs; the software does not assign codes `N18` Chronic kidney disease (CKD) (9 codes in the category). `N18.1` Chronic kidney disease, stage 1 `N18.2` Chronic kidney disease, stage 2 (mild) `N18.30` Chronic kidney disease, stage 3 unspecified `N18.31` Chronic kidney disease, stage 3a `N18.32` Chronic kidney disease, stage 3b `N18.4` Chronic kidney disease, stage 4 (severe) `N18.5` Chronic kidney disease, stage 5 `N18.6` End stage renal disease `N18.9` Chronic kidney disease, unspecified Source: official ICD-10-CM FY2027 code descriptions (extract in library/data/code_reference_fy2027.json).

Extended capabilities (licence required before commercial use) 0

Extended capabilities: published criteria cited by title and restated in our own words, no text reproduced; a licence or permission is needed before commercial use. Shown to coders always; on clinician screens only when the setting is on (now off).

Nothing in this section for this encounter.