Prerenal uremia/state

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ICD10 Diagnosis
Dx: Prerenal uremia/state
ICD10 code: R39.2
Pre-ICD10 counterpart: none assigned
Charlson/ALERT Scale: none
APACHE Como Component: none
APACHE Acute Component: none
External ICD10 Documentation
This diagnosis is a part of ICD10 collection.

Additional Info

  • This is a specific cause of acute (or occasionally subacute) renal disorder/insufficiency.
  • The usual marker for this entity is elevated serum urea and/or elevated serum creatinine PLUS an elevated urea:creatinine ratio. The normal value of this ratio (in the units used here) is 44, so a ratio > 66 is suggestive of a pre-renal state. While pre-renal patients are usually intravascularly depleted, this is not universally the case; any situation in which renal perfusion is reduced can give a pre-renal state, even without volume depletion. An example is bilateral renal artery stenosis.
  • If the patient qualifies, one could/should also code Kidney, acute renal failure NOS
  • Do not use this code if the patient has a pre-existing diagnosis of: Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15

Symptom/Sign/Test Result not needed when cause known

  • This code identifies a symptom or a sign, or an abnormal test result, not a disorder.
    • So, you must strive to code the cause of the symptom or sign, if known.
    • And if you do know the cause and code it, also coding this symptom/sign as Combined ICD10 codes is OK, but optional.
      • In the case of multi-system diagnoses, where a specific symptom/sign/test result is actually causing the hospital admission, and this would not be clear from just the condition itself, do make sure you code the symptom as well.
example   

Patient who has Wegener's granulomatosis is admitted due to Hemoptysis. Usually coding the Hemoptysis would be optional, but Wegener's granulomatosis doesn't always present with this, and unless it is causing problems it would not alone be a reason to admit the patient, so you should code the Hemoptysis.

  • Sometimes there may be multiple symptom/sign/test result that might or might NOT be related by virtue of having the same underlying cause. Since in the absence of KNOWING that cause, such assumptions may well be incorrect, do NOT combine them together if you are not certain they actually have the same underlying cause.

Repeated events

If this happens repeatedly during the same ward or unit stay, only code it the first time it happens, rather than each time it happens. See ICD10 codes only coded the first time for other diagnoses coded this way.

Example:   
  • A person has a self-limited episode of A-fib. It goes away and then recurs. Only code the first one.
  • A person has a self-limited episode of A-fib. It goes away but then he has an episode of V-tach. As this is a different diagnosis, both of these should be listed, but only code once each.
  • Patient comes in with hypokalemia. It’s treated and remits, but the next day it recurs. Only code the first time.
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Alternate ICD10s to consider coding instead or in addition

Renal failure codes:
Chronic kidney disease codes:

Candidate Combined ICD10 codes

Related CCI Codes

Data Integrity Checks (SMW)

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