Kidney, renal tubular acidosis (RTA, all types)

ICD10 Diagnosis
Dx:	Kidney, renal tubular acidosis (RTA, all types)
ICD10 code:	N25.8
Pre-ICD10 counterpart:	Other Renal Problems
Charlson/ALERT Scale:	Renal disease
APACHE Como Component:	none
APACHE Acute Component:	2019-0: Renal/Metabolic NOS, 2019-0: Metabolic/Renal 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.

• SMW
  • 2019-01-01
  • 2999-12-31
  • N25.8

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Additional Info

• RTA refers to a category of renal conditions where there is a metabolic acidosis due to an inability of the kidneys to excrete hydrogen ion (acid) IN THE PRESENCE OF AN ADEQUATE GLOMERULAR FILTRATION RATE (GFR), as usually indicated by the serum creatinine.
• The major implication of this is that you should not call it an RTA if the acidosis is due to "bad enough" renal failure to cause the acidosis
  • But the question is, "How high does the creatinine need to be to say that the metabolic acidosis is due to renal insufficiency/failure?"
  • We know the answer for chronic renal insufficiency/failure, where we know that you don't get clinical acidemia until the serum creatinine drifts above 350 or so (Archives of Internal Medicine 139:1099-1102, 1979)
  • For acute renal failure/AKI we don't really know this, but it's probably lower than the 350 value for serum creatinine. Operationally though, since RTAs are NOT acute conditions, it's best NOT to code an RTA in someone with AKI, no matter what their creatinine is, unless there was a pre-existing diagnosis of it in the absence of the degree of chronic renal dysfunction as indicated above.
• Several different types of RTA exist, which all have different syndromes and different causes. Type 1: distal RTA, Type 2: proximal RTA, Type 4 RTA: absolute hypoaldosteronism or aldosterone insensitivity

Renal tubular acidosis

Alternate ICD10s to consider coding instead or in addition

• Alcoholic ketoacidosis (AKA)
• Acidosis, NOS
• Diabetic ketoacidosis (DKA)
• Kidney, renal tubular disorder, NOS
• Kidney, acute tubular necrosis (ATN)

Candidate Combined ICD10 codes

Related CCI Codes

Data Integrity Checks (automatic list)

	App	Status
Query check CCI ICD10 Dialysis no Dx	CCMDB.accdb	implemented

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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