Table 1.

Verification criteria for end-stage renal disease and end-stage liver disease.

Criteria for end-stage renal disease
Hemodialysis/peritoneal dialysis	Provider documentation of chronic dialysis (>6 mos) in dialysis records, inpatient notes, outpatient clinic notes, or discharge summaries.
Kidney transplant	Provider documentation of kidney transplant in inpatient notes, outpatient clinic notes, or discharge summaries.
Criteria for end-stage liver disease
Ascites	Abdominal ultrasound report indicating ascites
	Abdominal CT report indicating ascites
	Abdominal MRI report indicating ascites
	Abdominal peritoneal fluid analysis result from paracentesis
	Provider documentation of ascites identified by any procedure listed above without the corroborating primary radiology or laboratory report
Variceal hemorrhage	Esophagogastroduodenoscopy (EGD) report of active variceal bleeding
	EGD report of recent variceal bleeding
	EGD report of nonbleeding varices in the setting of acute gastrointestinal bleeding without other causes identified
	Provider documentation of variceal hemorrhage identified by EGD procedure without corroborating primary EGD report
Spontaneous bacterial peritonitis	Ascitic fluid culture with bacterial growth
	Ascitic fluid absolute neutrophil count ≥ 250 cells/mm3
Hepatic encephalopathy	Mental confusion consistent with hepatic encephalopathy documented in a progress note of a patient with known chronic liver disease plus absence of any of the following conditions:
	(i) intracranial lesions, such as subdural hematoma, intracranial bleeding, stroke, tumor, and abscess
	(ii) infections, such as meningitis, encephalitis, and intracranial abscess
	(iii) metabolic encephalopathy, such as hypoglycemia, electrolyte imbalance, anoxia, hypercarbia, and uremia
	(iv) hyperammonemia from other causes, such as secondary to ureterosigmoidostomy and inherited urea cycle disorders
	(v) toxic encephalopathy from alcohol intake, such as acute intoxication, alcohol withdrawal, and Wernicke encephalopathy
	(vi) toxic encephalopathy from drugs, such as sedative hypnotics, antidepressants, antipsychotic agents, and salicylates
	(vii) organic brain syndrome
	(viii) postseizure encephalopathy
Hepatocellular carcinoma	Verified through medical record review and/or cancer registries