ARI

Legacy Content

This page is about the pre-ICD10 diagnosis coding schema. See the ICD10 Diagnosis List, or the following for similar diagnoses in ICD10:Kidney, acute renal failure NOS

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Category/Organ System:	Category: Renal (old)
Type:	Category: Medical Problem (old)
Main Diagnosis:	Acute Renal Insufficiency
Sub Diagnosis:
Diagnosis Code:	36400 - ARI-Acute Renal Insufficiency
Comorbid Diagnosis:	No
Charlson Comorbid coding (pre ICD10):	0 - 2
Program:	Critical Care and Medicine
Status:	Currently Collected

Acute Renal Iinsufficiency

Guideline

• Creatinine >250 mmol or a Rise >100 mmol from baseline over 24 hours
• a patient is not on chronic hemodialysis or peritoneal dialysis

• I don't think that just having a creatinine of >250 should automatically mean ARI. This could be the patient's baseline and therefore is a chronic issue. My opinion is to only use the rule of >100 mmol over baseline over 24 hours for acute renal insufficiency (without dialysis), or use ATN if this is documented. --LKolesar 07:13, 2014 October 8 (CDT)
  • Are we to change what we have being doing for over 10 years ?--PStein 09:54, 2014 October 15 (CDT)
    • I am just putting my opinion here, if any changes are done they will have to go through the task group first.--LKolesar 11:28, 2014 October 15 (CDT)
      • I always check what the pts baseline creatinine was prior to admission if the pt had chronic renal insuffiency and creatinine was 250 last admission I will code as mod CRI if the present creatinine was say 350 I will code acute RI in admits and CRI in comorbids ( acute on chronic )If the creat was the same as last admission say 250 and pt has CRI I only code in comorbids because it is not acute.-Shirley Kiesman
        • This is what I do also. This makes sense to me, not arbitrarily putting a value of >250 as acute renal insufficiency.--LKolesar 17:29, 2014 October 15 (CDT)

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There are a number of coding rules related to renal diagnoses, centralized info about them is in Renal Coding Considerations.