ICD-10 Coding for Acute Kidney Injury Superimposed on Chronic Kidney Disease(N17.9, N18.5)
Complete ICD-10-CM coding and documentation guide for Acute Kidney Injury Superimposed on Chronic Kidney Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Acute Kidney Injury Superimposed on Chronic Kidney Disease
N17-N19Primary Range
Acute kidney failure and chronic kidney disease
This range includes codes for acute kidney injury and chronic kidney disease, which are essential for coding AKI superimposed on CKD.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N17.9 | Acute kidney failure, unspecified | Use when AKI is the primary reason for admission or requires acute intervention. |
|
| N18.5 | Chronic kidney disease, stage 5 | Use when CKD stage 5 is present, especially if the patient is on dialysis. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for acute kidney injury superimposed on CKD
Essential facts and insights about Acute Kidney Injury Superimposed on Chronic Kidney Disease
Primary ICD-10-CM Codes for acute kidney injury superimposed on chronic kidney disease
Decision Criteria
clinical Criteria
- AKI is confirmed by a rapid rise in creatinine and requires immediate treatment.
documentation Criteria
- Documentation must specify AKI and its cause.
Applicable To
- Acute renal failure
Excludes
- Chronic kidney disease (N18.-)
Clinical Validation Requirements
- Rapid increase in serum creatinine (≥0.3 mg/dL in 48 hours)
- Oliguria (<0.5 mL/kg/hr for 6+ hours)
Code-Specific Risks
- Risk of under-documentation if the cause of AKI is not specified.
Coding Notes
- Ensure AKI is documented as the primary condition when it drives the treatment plan.
N18.5 - Chronic kidney disease, stage 5
Use when CKD stage 5 is present, especially if the patient is on dialysis.
Applicable To
- End stage renal disease
Excludes
- Acute kidney failure (N17.-)
Clinical Validation Requirements
- GFR <15 mL/min/1.73m²
- Patient on dialysis
Coding Notes
Document the stage of CKD clearly to ensure accurate coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Dependence on renal dialysis
Z99.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Acute Kidney Injury Superimposed on Chronic Kidney Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N17.9.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Use specific terms like 'acute kidney injury' or 'chronic kidney disease'.
Impact
Reimbursement: Incorrect sequencing can affect DRG assignment and reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate representation of patient condition.
Mitigation Strategy
Always code both AKI and CKD, sequencing AKI first if it meets UHDDS criteria.
Impact
Coding AKI without documenting CKD stage can lead to audit issues.
Mitigation Strategy
Ensure CKD stage is documented whenever AKI is coded.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Acute Kidney Injury Superimposed on Chronic Kidney Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Acute Kidney Injury Superimposed on Chronic Kidney Disease
Use these documentation templates to ensure complete and accurate documentation for Acute Kidney Injury Superimposed on Chronic Kidney Disease. These templates include all required elements for proper coding and billing.
AKI due to dehydration in CKD stage 3
Specialty: NephrologyRequired Elements
- Acute kidney injury diagnosis
- CKD stage
- Underlying cause of AKI
- Treatment plan
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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