ICD10 Guideline for Renal Coding

This page contains an ICD10 Coding Guideline for ICD10 collection. See ICD10 coding guidelines for similar pages.

See also Renal Coding Considerations (old) for coding in the old system.

General Considerations

• Renal-related issues in ICD10 may include any of these things:

About Coding Chronic Kidney Disease (CKD)

• The following ICD10 codes can apply to CKD

• When there is a Creatinine clearance / GFR listed, it will be used to specify between Stages 1, 2, 3, 4, 5

To calculate the GFR, use this easy website calculator: https://www.mdcalc.com/mdrd-gfr-equation

• It requires age, sex, race (black vs. white) and creatinine:
  • Unless you know otherwise, use "white" race as default
  • Use the most recent, stable, PRE-HOSPITAL creatinine value available
• When no creatinine clearance is listed, but the patient is a known dialysis patient then code Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15
• For all other CKD patients, i.e. those in whom we cannot easily identify the Stage, we’ll use Chronic kidney/renal disease, NOS (stage unspecified).

AKI

• ICD10 does not have specific diagnosis of AKI (acute kidney injury), instead the codes that cover this are any of:
  • Kidney, acute renal failure NOS
  • Kidney, acute renal failure, postprocedural

Candidate Combined ICD10 codes for renal codes

• Other codes you might want to use include:
  • Prerenal uremia/state
  • Hepatorenal syndrome
  • Kidney, nephropathy, drug or toxin induced
  • Nephritic syndrome, acute
  • Kidney, tubulo-interstitial nephritis/disease

ESRD vs Acute renal failure

• Never code both ESRD (Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5) and any of the acute renal failure codes; query check_ICD10_no_ESRD_w_ARF will give an error if you do.
  • The only time you might be inclined to do so is in the presence of a failed kidney transplant, where the ESRD would refer to the failure of the native kidney, and the acute renal failure to the transplanted kidney, but don't do it even there, because the FACT of a kidney transplant automatically indicates that ESRD had occurred.

There are a few restrictions about which renal diagnoses can be coded together. These checks are currently done partly by Pagasa (CRF vs ARF) and have been partly implemented in CCMDB.mdb.

Kidney transplant vs ESRD

• If the patient has a Past history, transplanted kidney, do not also code the Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15 that occurred in the native kidneys, which was the reason for the transplant because having had ESRD is implied in having had a kidney transplant.
  • Exception: If the transplanted kidney has completely failed (e.g. the patient is back on dialysis), then do also code: Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15, because now it applies to the transplanted kidney. Also code Kidney transplant, failure or rejection or unspecified complication.

Template:Data Integrity Checks

CCMDB Data Integrity Checks

• Query check_ICD10_no_ESRD_w_ARF
• Check ApARF CRF

• Can't check ICD10 ARF vs APACHE ARF

Template:Data Integrity Checks that can not be checked before sending

• Check CRF/ARF against TISS Dialysis

Related Articles

see Category:Renal Problem (old) for other renal problems