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Exact Dx synthetic data · demonstration

← How it decides

Two-sided comparison of documented kidney statements with the computed criteria

Compare with what the note says, in both directions; say 'not assessable' when the data cannot decide.

Rule and version
kidney_compare@1.1
Published source
Directions are this tool's definitions. Documentation rule: ICD-10-CM Official Guidelines for Coding and Reporting FY2026, Section I.A.19 (code assignment rests on the provider's statement, not on clinical criteria), so the comparison flags, it never assigns. Panel wording: ACDIS/AHIMA Guidelines for Achieving a Compliant Query Practice (2026 update): no diagnosis named beside 'criteria met', nothing implied by layout, no payment, quality or denial words, every value cited. https://www.cms.gov/medicare/coding-billing/icd-10-codes
Edition
this tool's comparison rules
Effective
from 2026-11-12
Role
direction of each finding
Status
draft: encoded from the published source; not yet signed off by a clinical reviewer
Clinical reviewer
—
Coding reviewer
—
Sponsor
none
Body hash
23fd394b4f02789eec020368dcfc30acab0cb62e411c3f4651d2bc778e3ee6cf

Thresholds and parameters

{
  "aki_precedence": "exclusion or no usable baseline -> NOT_ASSESSABLE; only the reverse comparison available -> CONSISTENT if stated, DEFINITIONS_DISAGREE if not; met at peak under 4 of 4 -> UNDER or CONSISTENT; 0 of 4 -> UNSUPPORTED or NONE (CONSISTENT / DEFINITIONS_DISAGREE when the reverse comparison is met); otherwise DEFINITIONS_DISAGREE",
  "ckd_precedence": "2021 equation not assessable -> NOT_ASSESSABLE; else note unreadable -> NOTE_UNREADABLE; else if the 2009 equation is assessable and gives a different status, stage or direction -> DEFINITIONS_DISAGREE (both shown; the tool never chooses); otherwise the 2021 direction",
  "counted_as_over": [
    "UNSUPPORTED"
  ],
  "counted_as_under": [
    "UNDER"
  ],
  "directions": {
    "CONSISTENT": "statement and computed result agree",
    "DEFINITIONS_DISAGREE": "the definitions (2009 vs 2021 equation, or the four creatinine baselines) lead to different directions; both are shown and the tool never chooses",
    "NONE": "criteria not met and nothing documented",
    "NOT_ASSESSABLE": "the data cannot decide (exclusion on record, insufficient history, no pre-admission baseline, or a statement the check cannot test); shown with the reason; counted in neither direction and not a review item",
    "NOT_ASSESSED": "the check does not apply to this encounter",
    "SPECIFICITY_GAP": "criteria met and the statement is unstaged or its stage differs from the computed G category",
    "UNDER": "criteria met (all definitions) and no matching statement for the encounter",
    "UNSUPPORTED": "a statement exists and the values affirmatively do not meet the criteria: two eGFR >= 60 at least 90 days apart against a stated stage 3a-5; or, for creatinine change, a pre-admission baseline with 0 of 4 baselines met and no reverse-comparison fall"
  },
  "statement_preference": "the current draft note's statement, else the encounter diagnosis list",
  "statement_stage": {
    "N18.1": "G1",
    "N18.2": "G2",
    "N18.30": "G3",
    "N18.31": "G3a",
    "N18.32": "G3b",
    "N18.4": "G4",
    "N18.5": "G5",
    "N18.6": "G5",
    "N18.9": null
  },
  "two_sided": "both directions are always computed; there is no setting that turns either off"
}

Boundary tests: 7/7 pass