ICD-10 Coding for Acute on Chronic Renal Failure(N17.9, N18.3)
Complete ICD-10-CM coding and documentation guide for Acute on Chronic Renal Failure. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Acute on Chronic Renal Failure
N17-N19Primary Range
Acute kidney failure and chronic kidney disease
This range includes codes for acute kidney injury (AKI), chronic kidney disease (CKD), and their combinations, which are essential for coding acute on chronic renal failure.
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 acute kidney injury is the primary focus of treatment and no specific cause is identified. |
|
| N18.3 | Chronic kidney disease, stage 3 | Use when CKD stage 3 is documented alongside acute kidney injury. |
|
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 on chronic renal failure
Essential facts and insights about Acute on Chronic Renal Failure
Primary ICD-10-CM Codes for acute on chronic renal failure
Decision Criteria
clinical Criteria
- Presence of acute kidney injury indicators with underlying CKD.
documentation Criteria
- Explicit mention of 'acute on chronic renal failure' in clinical notes.
Applicable To
- Acute kidney injury
Excludes
- Chronic kidney disease (N18.-)
Clinical Validation Requirements
- Increase in serum creatinine by ≥0.3 mg/dL within 48 hours
- Increase in serum creatinine to ≥1.5 times baseline within 7 days
- Urine output <0.5 mL/kg/hr for 6 hours
Code-Specific Risks
- Risk of undercoding if chronic component is not documented.
Coding Notes
- Ensure documentation clearly states 'acute on chronic renal failure' and includes CKD stage.
N18.3 - Chronic kidney disease, stage 3
Use when CKD stage 3 is documented alongside acute kidney injury.
Applicable To
- Moderate CKD
Excludes
- Acute kidney failure (N17.-)
Clinical Validation Requirements
- GFR 30-59 mL/min/1.73 m² for more than 3 months
Coding Notes
Ensure CKD stage is documented in all relevant clinical notes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Acute on Chronic Renal Failure to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N17.9.
Impact
Clinical: Inaccurate representation of patient's chronic condition., Regulatory: Non-compliance with ICD-10 coding guidelines., Financial: Potential loss of reimbursement for CKD management.
Mitigation Strategy
Ensure CKD stage is included in every relevant clinical note., Educate providers on the importance of CKD staging.
Impact
Reimbursement: May lead to reduced reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Poor data quality affecting clinical decision-making.
Mitigation Strategy
Ensure documentation supports the use of specific codes like N17.9 and N18.x.
Impact
Failure to document CKD stage can lead to audit flags.
Mitigation Strategy
Implement regular documentation audits and provider education.
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 on Chronic Renal Failure, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Acute on Chronic Renal Failure
Use these documentation templates to ensure complete and accurate documentation for Acute on Chronic Renal Failure. These templates include all required elements for proper coding and billing.
Acute on Chronic Renal Failure in Hospitalized Patient
Specialty: NephrologyRequired Elements
- Baseline creatinine levels
- Current creatinine levels
- Urine output
- CKD stage
- Etiology of AKI
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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