ICD-10 Coding for Albuminuria(R80.0, R80.1, E11.21)
Complete ICD-10-CM coding and documentation guide for Albuminuria. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Albuminuria
R80-R82Primary Range
Abnormal findings on examination of urine, without diagnosis
This range includes codes for proteinuria and albuminuria, which are key for documenting urine abnormalities.
Chronic kidney disease (CKD)
Used to document CKD stages when albuminuria is present as a symptom.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R80.0 | Isolated proteinuria | Use when proteinuria is detected without any underlying condition. |
|
| R80.1 | Persistent proteinuria, unspecified | Use when albuminuria is persistent and no specific cause is documented. |
|
| E11.21 | Type 2 diabetes mellitus with diabetic nephropathy | Use when albuminuria is a complication of diabetes. |
|
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 albuminuria
Essential facts and insights about Albuminuria
Primary ICD-10-CM Codes for albuminuria
Decision Criteria
clinical Criteria
- Proteinuria detected in a single test without follow-up
Applicable To
- Transient proteinuria
Excludes
- Proteinuria with nephrotic syndrome (N04.-)
Clinical Validation Requirements
- Single elevated protein level without persistent abnormality
Code-Specific Risks
- Misuse when persistent proteinuria is present
Coding Notes
- Ensure no underlying condition is documented.
R80.1 - Persistent proteinuria, unspecified
Use when albuminuria is persistent and no specific cause is documented.
Applicable To
- Persistent albuminuria
Excludes
- Proteinuria with nephrotic syndrome (N04.-)
Clinical Validation Requirements
- Three positive ACR tests over 3-6 months
Coding Notes
Document persistence with multiple tests.
E11.21 - Type 2 diabetes mellitus with diabetic nephropathy
Use when albuminuria is a complication of diabetes.
Applicable To
- Diabetic nephropathy
Excludes
- Diabetes with CKD (E11.22)
Clinical Validation Requirements
- Diabetes diagnosis with nephropathy symptoms
Coding Notes
Sequence diabetes code before CKD code.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Albuminuria to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R80.0.
Impact
Clinical: Inaccurate assessment of kidney function., Regulatory: Non-compliance with coding standards., Financial: Potential loss of reimbursement for CKD-related care.
Mitigation Strategy
Always include CKD stage when coding albuminuria., Cross-reference lab results with documentation.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use E11.21 for diabetic nephropathy with albuminuria.
Impact
Failure to sequence diabetes codes before CKD codes can lead to audit flags.
Mitigation Strategy
Educate coding staff on proper sequencing rules.
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 Albuminuria, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Albuminuria
Use these documentation templates to ensure complete and accurate documentation for Albuminuria. These templates include all required elements for proper coding and billing.
Diabetic nephropathy with albuminuria
Specialty: EndocrinologyRequired Elements
- Diabetes diagnosis
- ACR levels
- eGFR values
- CKD stage
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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