Kidney, acute renal failure NOS: Difference between revisions
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*Increase in serum creatinine to 1.5 times baseline or more within the last 7 days | *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 | *Urine output less than 0.5 mL/kg/hour for 6 hours | ||
{{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. | |||
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, | |||
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. | |||
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) | |||
== Alternate ICD10s to consider coding instead or in addition == | == Alternate ICD10s to consider coding instead or in addition == | ||
Revision as of 10:47, 2018 June 28
| 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
Do NOT use this code if the patient has a pre-existing diagnosis of: Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5
This code includes the following conditions that don't have separate ICD10 codes:
- Acute Kidney Injury (AKI)
- acute renal insufficiency (ARI)
Do not use this code if the AKI is postoperative or postprocedural, use Kidney, acute renal failure, postprocedural
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
Template:DiscussionThis 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.
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, 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.
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. Mlagadi 11:47, 2018 June 28 (CDT)
Alternate ICD10s to consider coding instead or in addition
- Kidney, acute tubular necrosis (ATN)
- Kidney, acute renal failure, postprocedural
- Prerenal uremia/state
- Chronic kidney disease (uremia, chronic renal insufficiency) Stage 1
- Chronic kidney disease (uremia, chronic renal insufficiency) Stage 2
- Chronic kidney disease (uremia, chronic renal insufficiency) Stage 3
- Chronic kidney disease (uremia, chronic renal insufficiency) Stage 4
- Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5
- Renal dialysis care, including dialysis itself
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.
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