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	ICD-10 CM Wikipedia ICD-10 Wikipedia WHO ICD10 documentation ICD10data.com

This diagnosis is a part of ICD10 collection.

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  • 2019-01-01
  • 2999-12-31
  • N19

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Additional Info

ESRD vs Acute Renal Failure

• Do NOT code both
  • Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15

AND

• Any of the acute renal failure diagnoses (Kidney, acute tubular necrosis (ATN), Kidney, acute renal failure NOS, Kidney, renal failure/insufficiency/uremia, unspecified as acute or chronic, Kidney, acute renal failure, postprocedural)

• 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.

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)

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Alternate ICD10s to consider coding instead or in addition

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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Show all ICD10 Subcategories

ICD10 Categories: ANCA-associated Vasculitis (AAV), Abdominal trauma, Abortion, Acute intoxication, Addiction, Adrenal Insufficiency, Adverse effect, Alcohol related, Allergy, Anemia, Anesthetic related, Aneurysm, Antibiotic resistance, Antidepressant related, Aortic Aneurysm, Arrhythmia, Arterial thromboembolism, Asthma, Atherosclerosis, Awaiting/delayed transfer, Bacteria, Benign neoplasm, Breast disease, Burn, COVID, Cannabis related, Cardiac septum problem, Cardiovascular, Cerebral Hemorrhage/Stroke, Chemical burn, Chronic kidney disease, Cirrhosis, Cocaine related, Decubitus ulcer, Delirium, Dementia, Diabetes, Diagnosis implying death, Double duty pathogen, ENT, Encephalitis, Encephalopathy, Endocrine disorder, Endocrine neoplasm, Exposure, Eye, Female genital neoplasm, Fistula, Fracture, Fungus, GI ulcer, Gastroenteritis, Gastrointestinal, Gastrointestinal neoplasm, Hallucinogen related, Has one, Head trauma, Head trauma (old), Healthcare contact, Heart valve disease, Heme/immunology, Heme/immunology neoplasm, Hemophilia, Hemorrhage, Hepatitis, Hereditary/congenital, Hernia, Hypertension, Hypotension, Iatrogenic, Iatrogenic infection, Iatrogenic mechanism, Imaging, Infection requiring pathogen, Infection with implied pathogen, Infectious disease, Inflammatory Bowel Disease, Influenza, Inhalation, Intra-abdominal infection, Ischemia, Ischemic gut, Ischemic heart disease, Joint/ligament trauma, Leukemia, Liver disease, Liver failure, Lower limb trauma, Lower respiratory tract infection, Lymphoma, Male genital neoplasm, Mechanism, Meningitis, Metabolic/nutrition, Metastasis, Misc, Muscle problem, Muscles/tendon trauma, Musculoskeletal/soft tissue, Musculoskeletal/soft tissue neoplasm... further results