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| {{ICD10 transition status | | {{ICD10 transition status |
| | OldDxArticle = ARF, ARI | | | OldDxArticle = ARF; ARI |
| | CurrentStatus = freshly automatically generated article | | | CurrentStatus = needs review |
| | InitialEditorAssigned = Michelle Lagadi | | | InitialEditorAssigned = Michelle Lagadi |
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| | BugRequired= | | | BugRequired= |
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| {{ICD10 category|Renal/urinary}}{{ICD10 category|Metabolic/nutrition}} | | {{ICD10 category|Renal/urinary}}{{ICD10 category|Renal failure}} |
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| == Additional Info == | | == Additional Info == |
| Do NOT use this code if the patient has a '''pre-existing''' diagnosis of: '''[[Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5]]'''
| | '''Excludes:''' |
| | *[[Kidney, acute tubular necrosis (ATN)]] - This code {{PAGENAME}} is, by definition, for acute renal failure that is '''"not otherwise specified" (NOS)'''. ATN is more specific, so if it is right, use it |
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| This code includes the following conditions that don't have separate ICD10 codes:
| | {{ICD10 Guideline KDIGO Guidelines for Acute Renal Failure}} |
| * '''Acute Kidney Injury''' (AKI)
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| * '''acute renal insufficiency''' ([[ARI]])
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| Do not use this code if the AKI is postoperative or postprocedural, use [[Kidney, acute renal failure, postprocedural]]
| | {{ICD10 Guideline ESRD vs Acute renal failure}} |
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| The [http://kdigo.org/clinical_practice_guidelines/pdf/KDIGO%20AKI%20Guideline.pdf KDIGO guidelines] identify that this is present if any one or more of the following are true:
| | == Alternate ICD10s to consider coding instead or in addition == |
| *Increase in serum creatinine by 26 micromoles/L or more within 48 hours
| | {{ListICD10Category | categoryName = Renal failure}} |
| *Increase in serum creatinine to 1.5 times baseline or more within the last 7 days
| | {{ListICD10Category | categoryName = Chronic kidney disease}} |
| *Urine output less than 0.5 mL/kg/hour for 6 hours
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| {{discussion}}This definition is in contrast to the old ARF definition in which we code acute renal failure ONLY if the patient receives dialysis during their admission. There creatinine levels/urine output is not enough to code renal failure (the only exception to this rule was in the ICU apache score, in which you could code ARF in the apache tab based on creat/urine output). The codes will be inconsistent between the old diagnosis codes and the ICD10. | |
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| In addition to this, if we wanted to code acute renal insufficiency our criteria was as follows: A Rise >100 mmol from baseline over 24 hours,
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| If the prior Creatinine level is unknown use > 250 as a guideline to code ARI. If patients baseline creatinine was > or equal to 250 last admission code as ARI if the present creatinine was 350 or more.
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| I just want to make sure that we are coding this properly, as we have many patients coming in with renal issues/not sure how important consistency between collecting the old way and the new way is. [[User:Mlagadi|Mlagadi]] 11:47, 2018 June 28 (CDT)
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| == Alternate ICD10s to consider coding instead or in addition ==
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| *[[Kidney, acute tubular necrosis (ATN)]]
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| *[[Kidney, acute renal failure, postprocedural]]
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| *[[Prerenal uremia/state]]
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| *[[Chronic kidney disease (uremia, chronic renal insufficiency) Stage 1]]
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| *[[Chronic kidney disease (uremia, chronic renal insufficiency) Stage 2]]
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| *[[Chronic kidney disease (uremia, chronic renal insufficiency) Stage 3]]
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| *[[Chronic kidney disease (uremia, chronic renal insufficiency) Stage 4]]
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| *[[Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5]]
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| *[[Renal dialysis care, including dialysis itself]]
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| == Candidate [[Combined ICD10 codes]] == | | == Candidate [[Combined ICD10 codes]] == |
| *Also code the cause, if known. | | *Also code the cause, if known. |
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| == {{Data Integrity Checks}} == | | == Related CCI Codes == |
| There are a number of coding rules related to renal diagnoses, centralized info about them is in '''[[Renal Coding Considerations for ICD10]]'''. | | |
| | == Data Integrity Checks == |
| | There are a number of coding rules related to renal diagnoses, centralized info about them is in '''[[ICD10 Guideline for Renal Coding]]'''. |
| | {{Data Integrity Check List}} |
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| == Related CCI Codes == | | == Legacy Info == |
| | {{Collapsable |
| | | always= Legacy only |
| | | full= |
| | We understand that the definition in the ICD10 codes is different than the definition in [[ARF (Diagnosis)]] and [[ARI]] and [[CRF - Chronic Renal Failure]] was. We are OK with that and will use the new definitions for the new codes, and the old ones for the old codes. Hopefully we can limit the amount of time where we consider both. |
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| == Related Articles == | | == Related Articles == |