MELD-Na Score
Quantifies end-stage liver disease severity for transplant prioritization
- Highest activation tier
- Mandatory
- How it is scored
- Scored in code; a detected disagreeing draft value is flagged for correction
- Care settings
- Inpatient, Outpatient
When it activates
Scribeable activates a calculator from the encounter. The MELD-Na Score can activate when the transcript or pasted chart context documents any of these:
- Cirrhosis severity assessment
- Transplant evaluation
- Decompensated liver disease
- Hepatic encephalopathy
- Ascites management
A coded diagnosis can also activate it. ICD-10 prefixes carried by the registry: K70, K71, K72, K74, K76.
Note-type scope: it activates on notes whose subject resolves to hepatology, gi, hospital medicine, critical care. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.
Inputs the note needs
5 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; an input marked "asks you" is requested as a clarification when it is undocumented.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| Serum creatinine | lab | mg/dL | UNOS clamp 1.0–4.0; set to 4.0 when on dialysis. |
| Total bilirubin | lab | mg/dL | Floored at 1.0 in the MELD formula. |
| INR | lab | Floored at 1.0 in the MELD formula. | |
| Serum sodium | lab | mEq/L | Clamped to 125–137 in the MELD-Na adjustment. |
| Dialysis in past weekoptional | history | 2 or more dialysis sessions in the past week → creatinine set to 4.0. |
Scoring
MELD-Na uses creatinine, bilirubin, INR, sodium, and dialysis status
MELD from (Cr Serum creatinine, bili Total bilirubin, INR INR, Na Serum sodium); Na-adjusted
Interpretation
<=9: 1.9% 3-month mortality. 10-19: 6%. 20-29: 19.6%. 30-39: 52.6%. >=40: 71.3%. Refer for MELD >=10.
Evidence
Sources carried in Scribeable's citation registry for this calculator.
- Kim WR et al. Hyponatremia and mortality among patients on the liver-transplant waiting list (MELD-Na)Kim et al. (MELD-Na) 2016 · 2016 · UNOS · link last verified 2026-03-23
How Scribeable handles it in the note
When an encounter activates the MELD-Na Score at the mandatory tier, Scribeable resolves its inputs from the transcript, the pasted chart context and any charted labs, and asks you for a missing input you can supply before the note is finalised. Bedside-exam and separately ordered study values are not requested one input at a time; a calculator that carries a combined clarification question may still put that single question to you.
The score is computed in code from the resolved inputs, not recalled by the language model. If the draft states a MELD-Na Score value that disagrees with the computed one, the disagreement is flagged to the second drafting pass, which is instructed to correct the score and its interpretation before you see the note.
Classified as a staging or classification system: activated strictly, because a wrong stage on the wrong patient is a documentation hazard.
See it activate on your own encounter
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