Kidney, acute tubular necrosis (ATN): Difference between revisions

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*Common causes of ATN include shock, and nephrotoxic drugs.

*ATN is a diagnosis ''usually'' made clinically by: presence of AKI + presence of a known cause of ATN + urine electrolytes showing consistent findings (e.g. fractional excretion of sodium of >1%) + urine sediment showing lots of renal tubular epithelial cells.

*If you use this code, ~~there is no absolute requirement to~~ also code ~~one~~ of the AKI/ARF ~~codes~~, ~~though you can if you want to.~~

*If you use this code, you should NOT also use the [[Kidney, acute renal failure NOS]] code -- as the latter is for types of acute renal failure that are NOT otherwise specified and ATN is exactly that, a type of acute renal failure that IS otherwise specified.

*In any case, since ATN is a specific type/cause of AKI/ARF, to qualify the patient must have AKI/ARF, as defined by KDIGO:

~~{{Discuss | who=all |question=~~

*If a patient has ATN on admission and later requires CRRT for kidney failure, do we need to put an acquired code of [[Kidney, acute renal failure NOS]] or not? The crrt goes into the CCI codes. --[[User:LKolesar|LKolesar]] 12:11, 2018 December 5 (CST)

** What is special about this dx that would have you not code it? Is it that you are wondering whether coding a CCI means you don't have to code a dx? They are different things, you would still need to code the dx. Am I misunderstanding the question? Ttenbergen 07:09, 2018 December 14 (CST)

}}

== Alternate ICD10s to consider coding instead or in addition ==

*[[Chronic kidney disease ~~(chronic renal insufficiency, uremia) Stage 1]]~~

*[[Chronic kidney disease (chronic renal insufficiency, uremia) Stage 2]]

*[[Chronic kidney disease (chronic renal insufficiency, uremia) Stage 3]]

*[[Chronic kidney disease (chronic renal insufficiency, uremia) Stage 4]]

*[[Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5]]

*[[Hemoglobinuria]]

*[[Anuria or oliguria]]

== Candidate [[Combined ICD10 codes]] ==

*Also code the cause, if known.

== Related CCI Codes ==

== Data Integrity Checks ==

There are a number of coding rules related to renal diagnoses, centralized info about them is in '''[[Renal Coding ~~Considerations for ICD10~~]]'''.

There are a number of coding rules related to renal diagnoses, centralized info about them is in '''[[ICD10 Guideline for Renal Coding]]'''.

~~== Related CCI Codes ==~~

~~{{Data Integrity Check List}}~~

== Related Articles ==

@@ Line 15: / Line 15: @@
 *Common causes of ATN include shock, and nephrotoxic drugs.
 *ATN is a diagnosis ''usually'' made clinically by:  presence of AKI + presence of a known cause of ATN + urine electrolytes showing consistent findings (e.g. fractional excretion of sodium of >1%) + urine sediment showing lots of renal tubular epithelial cells.
-*If you use this code, there is no absolute requirement to also code one of the AKI/ARF codes, though you can if you want to.
+*If you use this code, you should NOT also use the [[Kidney, acute renal failure NOS]] code -- as the latter is for types of acute renal failure that are NOT otherwise specified and ATN is exactly that, a type of acute renal failure that IS otherwise specified.
+*In any case, since ATN is a specific type/cause of AKI/ARF, to qualify the patient must have AKI/ARF, as defined by KDIGO:
+{{ICD10 Guideline KDIGO Guidelines for Acute Renal Failure}}
 {{ICD10 Guideline ESRD vs Acute renal failure}}
-{{Discuss | who=all |question=
-*If a patient has ATN on admission and later requires CRRT for kidney failure, do we need to put an acquired code of [[Kidney, acute renal failure NOS]] or not?  The crrt goes into the CCI codes.  --[[User:LKolesar|LKolesar]] 12:11, 2018 December 5 (CST)
-** What is special about this dx that would have you not code it? Is it that you are wondering whether coding a CCI means you don't have to code a dx? They are different things, you would still need to code the dx. Am I misunderstanding the question? Ttenbergen 07:09, 2018 December 14 (CST)
-}}
 == Alternate ICD10s to consider coding instead or in addition ==
 {{ListICD10Category | categoryName = Renal failure}}
+{{ListICD10Category | categoryName = Chronic kidney disease}}
-*[[Chronic kidney disease (chronic renal insufficiency, uremia) Stage 1]]
-*[[Chronic kidney disease (chronic renal insufficiency, uremia) Stage 2]]
-*[[Chronic kidney disease (chronic renal insufficiency, uremia) Stage 3]]
-*[[Chronic kidney disease (chronic renal insufficiency, uremia) Stage 4]]
-*[[Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5]]
 *[[Hemoglobinuria]]
+*[[Anuria or oliguria]]
 == Candidate [[Combined ICD10 codes]] ==
 *Also code the cause, if known.
+== Related CCI Codes ==
 == Data Integrity Checks ==
-There are a number of coding rules related to renal diagnoses, centralized info about them is in '''[[Renal Coding Considerations for ICD10]]'''.
+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}}
-== Related CCI Codes ==
-{{Data Integrity Check List}}
 == Related Articles ==