ICD-10 Coding for Anemia in End-Stage Renal Disease (ESRD)(N18.6, D63.1, Z99.2)
Complete ICD-10-CM coding and documentation guide for Anemia in End-Stage Renal Disease (ESRD). 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 (ESRD)
N18-N19Primary Range
Chronic kidney disease (CKD) and related conditions
This range includes codes for chronic kidney disease stages, including ESRD, which is crucial for coding anemia in ESRD.
Anemia in chronic diseases classified elsewhere
This range includes codes for anemia in chronic diseases, such as CKD, which is necessary for coding anemia in ESRD.
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, especially if they are on dialysis. |
|
| D63.1 | Anemia in chronic kidney disease | Use when anemia is directly linked to CKD. |
|
| Z99.2 | Dependence on renal dialysis | Use to indicate the patient is dependent 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 anemia in ESRD
Essential facts and insights about Anemia in End-Stage Renal Disease (ESRD)
Primary ICD-10-CM Codes for anemia in esrd
Decision Criteria
clinical Criteria
- Patient has ESRD and is on dialysis.
Applicable To
- Chronic kidney disease stage 5 requiring dialysis
Excludes
- Acute kidney failure (N17.-)
Clinical Validation Requirements
- eGFR <15 mL/min
- Patient on dialysis
Code-Specific Risks
- Incorrect sequencing if anemia is coded as primary
Coding Notes
- N18.6 should always be sequenced first in cases of anemia due to ESRD.
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-D63.9)
Clinical Validation Requirements
- Hemoglobin <13 g/dL for men or <12 g/dL for women
- Documentation linking anemia to CKD
Coding Notes
D63.1 is a manifestation code and should not be used as a primary diagnosis.
Z99.2 - Dependence on renal dialysis
Use to indicate the patient is dependent on dialysis.
Applicable To
- Patient on dialysis
Clinical Validation Requirements
- Patient is receiving dialysis treatment
Coding Notes
Always include Z99.2 when the patient is on dialysis.
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 (ESRD) to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N18.6.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with coding guidelines., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Ensure documentation explicitly links anemia to CKD., Use structured templates for consistency.
Impact
Reimbursement: May lead to incorrect DRG assignment and reimbursement issues., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate data on anemia prevalence in CKD patients.
Mitigation Strategy
Ensure documentation links anemia to CKD and use D63.1.
Impact
Reimbursement: Potential underpayment due to incomplete coding., Compliance: Failure to meet coding standards., Data Quality: Incomplete patient treatment data.
Mitigation Strategy
Always include Z99.2 when the patient is on dialysis.
Impact
N18.6 must be sequenced first for anemia in ESRD.
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 Anemia in End-Stage Renal Disease (ESRD), with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Anemia in End-Stage Renal Disease (ESRD)
Use these documentation templates to ensure complete and accurate documentation for Anemia in End-Stage Renal Disease (ESRD). These templates include all required elements for proper coding and billing.
Nephrology Progress Note for Anemia in ESRD
Specialty: NephrologyRequired Elements
- Diagnosis of ESRD
- Hemoglobin levels
- Dialysis status
- Link between anemia and CKD
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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