P07 KE-P07 · 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-00007 · front-engine 1.2 · replay 26f12c03bd2892ee…

Library check LRUN-00007 · library_default_set@1.1 · library-engine 1.1 · replay fec3c1a4134aa58e… · Data (JSON)

Core definitions 1

Core definitions: condition families for this encounter (1)
Condition family	What the record supports	What the note states	Visit diagnosis entries	Assessment
Kidney disease stage (filtering rate) measured · side-panel condition	`front_kidney_stage_wording@1.0` Draft · pending review Record meets: Chronic kidney disease stage 4 Filtering rate 25.6 on 2026-05-14 (G4 range) and 23.4 on 2026-11-10 (G4 range) · L-0014 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 25.6 on 2026-05-14 and 23.4 on 2026-11-10 (G4 range) · not met 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 25.6 on 2026-05-14 and 23.4 on 2026-11-10 (G4 range) · not met Chronic kidney disease stage 3a · needs filtering rate 45-59 on two results at least 90 days apart · record: filtering rate 25.6 on 2026-05-14 and 23.4 on 2026-11-10 (G4 range) · not met Chronic kidney disease stage 3b · needs filtering rate 30-44 on two results at least 90 days apart · record: filtering rate 25.6 on 2026-05-14 and 23.4 on 2026-11-10 (G4 range) · not met Chronic kidney disease stage 4 · needs filtering rate 15-29 on two results at least 90 days apart · record: filtering rate 25.6 on 2026-05-14 and 23.4 on 2026-11-10 (G4 range) · met Chronic kidney disease stage 5 · needs filtering rate below 15 on two results at least 90 days apart · record: filtering rate 25.6 on 2026-05-14 and 23.4 on 2026-11-10 (G4 range) · 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	The record supports it; neither stated in the note nor entered Two kidney results 180 days apart are in the G4 range (filtering rate 25.6 on 2026-05-14 and 23.4 on 2026-11-10); the note doesn't mention kidney function. Clinician's response to the side-panel card: No response yet · offer OF-000004 Draft a query
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) 1

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).

Extended capabilities (licence required before commercial use): condition families for this encounter (1)
Condition family	What the record supports	What the note states	Visit diagnosis entries	Assessment
Chronic obstructive pulmonary disease (airflow component) judgement tier	`gold2026_copd_airflow@1.0` Draft · pending review GOLD 2 (moderate): 50% ≤ FEV1 <80% predicted fev1 fvc ratio post bd 0.58 ratio 2026-09-11 10:00 · LM-P07-01 fev1 pct predicted post bd 62 % 2026-09-11 10:00 · LM-P07-02 Window: 1095 days before the check. Citation COPD airflow obstruction grade by post-bronchodilator spirometry (GOLD 2026) gold2026_copd_airflow@1.0 In our words: When FEV1/FVC after a bronchodilator is below 0.7: FEV1 80% of predicted or more is grade 1; 50 to under 80% grade 2; 30 to under 50% grade 3; under 30% grade 4. A ratio of 0.7 or more shows no obstruction by this fixed ratio. Global Initiative for Chronic Obstructive Lung Disease (GOLD), Global Strategy for Prevention, Diagnosis and Management of COPD: 2026 Report — Pocket Guide (2026) · Figure 2.10 (PDF page 20); key points (PDF page 11) · source Licence: cited source; wording is ours (numbers restated, no text reproduced). Source checked: opened. No endorsement by the cited bodies is implied. Contested: The fixed ratio 0.7 is contested against the lower limit of normal (z-score) approach used by ATS/ERS interpretation standards (not opened); the fixed ratio over-diagnoses in older and under-diagnoses in younger adults. Not encoded: COPD also needs the appropriate clinical context (symptoms, exposures); the grade describes airflow obstruction only and never says COPD is present. Symptom and exacerbation assessment (GOLD ABE groups, mMRC, CAT) is not encoded. Pre-COPD and PRISm are not encoded. Whether the test was post-bronchodilator is asserted by the sender through the analyte name.	COPD COPD	`J44.9` Chronic obstructive pulmonary disease, unspecified (visit diagnosis list (synthetic))	Cannot be assessed judgement tier: the record shows these values; the condition needs clinical judgement
Whole code category, for reference (no code is selected, ranked or suggested): Chronic obstructive pulmonary disease (airflow component) Coders only reference for coders — the clinician's documented statement governs; the software does not assign codes `J44` Other chronic obstructive pulmonary disease: distinguishes COPD with acute lower respiratory infection, with acute exacerbation, bronchiolitis obliterans, other specified, unspecified; the code set does not distinguish GOLD grades (5 codes in the category). `J44.0` Chronic obstructive pulmonary disease with (acute) lower respiratory infection `J44.1` Chronic obstructive pulmonary disease with (acute) exacerbation `J44.81` Bronchiolitis obliterans and bronchiolitis obliterans syndrome `J44.89` Other specified chronic obstructive pulmonary disease `J44.9` Chronic obstructive pulmonary disease, unspecified Source: official ICD-10-CM FY2027 code descriptions (extract in library/data/code_reference_fy2027.json).