Kidney, acute renal failure NOS: Difference between revisions
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* [[Kidney, acute renal failure, postprocedural]] | * [[Kidney, acute renal failure, postprocedural]] | ||
This code includes the following conditions that don't have separate ICD10 codes: | This code includes the following conditions that don't have separate ICD10 codes: | ||
* '''Acute Kidney Injury''' (AKI) | * '''Acute Kidney Injury''' (AKI) | ||
* '''Acute Renal Insufficiency''' ([[ARI]]) | * '''Acute Renal Insufficiency''' ([[ARI]]) | ||
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: | 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: | ||
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*I double checked with our lab values, and it looks like our EPR results are measured in micromoles/L. Using the guidelines listed above, that would mean that any patient who has a rise in creatinine over a 2 day period equal or greater to 26, would be coded as "acute renal failure NOS". For example, a patient whose creatinine rises from 120 to 150 within 48 hours, would receive this code. I feel like I am reading these instructions wrong, because this would mean a large number of patients would fall into this category.[[User:Mlagadi|Mlagadi]] 14:01, 2018 October 16 (CDT) | *I double checked with our lab values, and it looks like our EPR results are measured in micromoles/L. Using the guidelines listed above, that would mean that any patient who has a rise in creatinine over a 2 day period equal or greater to 26, would be coded as "acute renal failure NOS". For example, a patient whose creatinine rises from 120 to 150 within 48 hours, would receive this code. I feel like I am reading these instructions wrong, because this would mean a large number of patients would fall into this category.[[User:Mlagadi|Mlagadi]] 14:01, 2018 October 16 (CDT) | ||
** I'll leave this for Allan to confirm, but the definition on p.19 of [http://kdigo.org/clinical_practice_guidelines/pdf/KDIGO%20AKI%20Guideline.pdf KDIGO guidelines] does indeed say so, even though it uses the cut-off 26.5 and I am not sure why we would have deviated from that. }} | ** I'll leave this for Allan to confirm, but the definition on p.19 of [http://kdigo.org/clinical_practice_guidelines/pdf/KDIGO%20AKI%20Guideline.pdf KDIGO guidelines] does indeed say so, even though it uses the cut-off 26.5 and I am not sure why we would have deviated from that. }} | ||
{{ICD10 Guideline ESRD vs Acute renal failure}} | |||
== Alternate ICD10s to consider coding instead or in addition == | == Alternate ICD10s to consider coding instead or in addition == | ||
Revision as of 00:24, 2018 October 22
| ICD10 Diagnosis | |
| Dx: | Kidney, acute renal failure NOS |
| ICD10 code: | N17.9 |
| Pre-ICD10 counterpart: | ARF, ARI |
| Charlson/ALERT Scale: | none |
| APACHE Como Component: | none |
| APACHE Acute Component: | 2019-0: Renal/Metabolic NOS, 2019-0: Metabolic/Renal NOS |
| Start Date: | |
| Stop Date: | |
| External ICD10 Documentation | |
This diagnosis is a part of ICD10 collection.
Additional Info
Excludes:
This code includes the following conditions that don't have separate ICD10 codes:
- Acute Kidney Injury (AKI)
- Acute Renal Insufficiency (ARI)
The KDIGO guidelines identify that this is present if any one or more of the following are true:
- Increase in serum creatinine by 26 micromoles/L or more within 48 hours
- Increase in serum creatinine to 1.5 times baseline or more within the last 7 days
- Urine output less than 0.5 mL/kg/hour for 6 hours
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ESRD vs Acute Renal Failure
- AND
- UNLESS the patient has had a renal transplant and the transplanted kidney was functioning (and thus can experience acute renal failure)
About "Acute on Chronic renal failure"
- Our definition for CRF includes two things, as above. If you are on dialysis then it is technically not possible to also have acute renal failure. And while our threshold of creatinine clearance < 15 ml/min USUALLY gets people on dialysis, that's not always the case. In other words, there are some people who don't need to start dialysis until their clearance is <10 or even 8 ml/min. THOSE people who by our definition have Stage 5 CKD cannot have ARF but rather this is considered a progression of their underlying disease. Instead of coding ARF, code the reason for dialysis ie. Fluid overload, Hyperkalemia, severe or symptomatic etc combined with Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15
- And of course, if you previously had Stage 5, were on dialysis, then got a successful renal transplant, then you CAN get acute renal failure in your graft.
Alternate ICD10s to consider coding instead or in addition
| Renal failure codes: |
Candidate Combined ICD10 codes
- Also code the cause, if known.
Template: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.
Related CCI Codes
Legacy Info
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.
Related Articles
Show all ICD10 Subcategories