ICD-10 Coding for Anemia in End-Stage Renal Disease(N18.6, D63.1)
Complete ICD-10-CM coding and documentation guide for Anemia in End-Stage Renal Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Anemia in End-Stage Renal Disease
N18-N19Primary Range
Chronic kidney disease (CKD) and related conditions
This range includes codes for chronic kidney disease, which is the underlying condition for anemia in ESRD.
Anemia in chronic diseases classified elsewhere
This range includes codes for anemia associated with chronic diseases like 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 |
|---|---|---|---|
| N18.6 | End stage renal disease | Use when the patient has ESRD and requires dialysis. |
|
| D63.1 | Anemia in chronic kidney disease | Use when anemia is directly linked to CKD. |
|
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: How do you code anemia in ESRD?
Essential facts and insights about Anemia in End-Stage Renal Disease
Primary ICD-10-CM Codes for anemia esrd
Decision Criteria
clinical Criteria
- Patient diagnosed with ESRD and undergoing dialysis.
Applicable To
- Chronic kidney disease stage 5 requiring chronic dialysis
Excludes
- Acute kidney failure (N17.-)
D63.1 - Anemia in chronic kidney disease
Use when anemia is directly linked to CKD.
Applicable To
- Anemia due to CKD
Excludes
- Anemia due to other chronic diseases (D63.0)
Clinical Validation Requirements
- Hemoglobin <11 g/dL in women or <12 g/dL in men
- Documented link between anemia and CKD
Coding Notes
Do not use as a primary code; always link to CKD.
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 Anemia in End-Stage Renal Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N18.6.
Impact
Clinical: Misrepresentation of patient's condition., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Ensure documentation explicitly states the cause of anemia., Regular training on documentation standards.
Impact
Reimbursement: Incorrect DRG assignment leading to potential underpayment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Ensure documentation specifies anemia due to CKD.
Impact
Inadequate documentation linking anemia to CKD can trigger audits.
Mitigation Strategy
Ensure all documentation explicitly links anemia to CKD.
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 Anemia in End-Stage Renal Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Anemia in End-Stage Renal Disease
Use these documentation templates to ensure complete and accurate documentation for Anemia in End-Stage Renal Disease. These templates include all required elements for proper coding and billing.
Anemia in ESRD patient on dialysis
Specialty: NephrologyRequired Elements
- Hemoglobin levels
- Iron studies
- ESA dosage
- Linkage between anemia and ESRD
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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