Kidney, renal failure/insufficiency/uremia, unspecified as acute or chronic
| ICD10 Diagnosis | |
| Dx: | Kidney, renal failure/insufficiency/uremia, unspecified as acute or chronic |
| ICD10 code: | N19 |
| Pre-ICD10 counterpart: | none assigned |
| Charlson/ALERT Scale: | Renal disease |
| APACHE Como Component: | none |
| APACHE Acute Component: | 2019-0: Metabolic/Renal NOS, 2019-0: Renal/Metabolic NOS |
| Start Date: | |
| Stop Date: | |
| External ICD10 Documentation | |
This diagnosis is a part of ICD10 collection.
Additional Info
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.
Template:Discussion This specific kidney code states it is "unspecified as acute or chronic". I tried to use this code to hook up to make a uremic pericardial effusion/ pericarditis but I get the error message because this is a Stage 5 CRF patient. Because this code is unspecified I think it should be allowed to use it in this case unless there is a better option for chronic uremia causing pericarditis and effusion. Need advice on this. --LKolesar 11:52, 2019 May 6 (CDT) **Another option could be to link pericarditis with Abnormal blood chemistry NOS. This wouldn't be as specific though...Mlagadi 12:00, 2019 May 6 (CDT)
Alternate ICD10s to consider coding instead or in addition
| Renal failure codes: |
Candidate Combined ICD10 codes
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.
Data Integrity Checks (automatic list)
| App | Status | |
|---|---|---|
| Can't check ICD10 ARF vs APACHE ARF | CCMDB.accdb | declined |
| Query check CCI ICD10 Dialysis no Dx | CCMDB.accdb | implemented |
| Query check_ICD10_ESRD_and_AKI_only_if_transplant | CCMDB.accdb | implemented |
| Query check ICD10 ESRD vs ARF | CCMDB.accdb | not feasible |
| Check CRF vs ARF across multiple encounters | Centralized data front end.accdb | declined |
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