ICD-10 Coding for Chronic Kidney Disease Stage 5(N18.5, N18.6)
Complete ICD-10-CM coding and documentation guide for Chronic Kidney Disease Stage 5. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Chronic Kidney Disease Stage 5
N18.5-N18.6Primary Range
Chronic Kidney Disease, Stage 5 and End-Stage Renal Disease
These codes are used to classify the severity of chronic kidney disease at its most advanced stage.
Hypertensive Chronic Kidney Disease
Used when CKD is due to hypertension, with or without heart disease.
Type 2 Diabetes Mellitus with Diabetic Chronic Kidney Disease
Used when CKD is due to type 2 diabetes.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N18.5 | Chronic Kidney Disease, Stage 5 | Use when CKD stage 5 is documented without dialysis dependence. |
|
| N18.6 | End-stage renal disease | Use when CKD stage 5 progresses to ESRD with 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: How to code CKD stage 5 in ICD-10
Essential facts and insights about Chronic Kidney Disease Stage 5
Primary ICD-10-CM Codes for chronic kidney disease 5
Decision Criteria
clinical Criteria
- eGFR <15 mL/min/1.73m² for at least 3 months
documentation Criteria
- Explicit mention of CKD stage 5 without dialysis
Applicable To
- CKD stage 5 without dialysis
Excludes
- End-stage renal disease (N18.6)
Clinical Validation Requirements
- eGFR <15 mL/min/1.73m² for at least 3 months
- Symptoms of uremia or fluid overload
Code-Specific Risks
- Misclassification if dialysis is initiated
Coding Notes
- Ensure documentation specifies CKD stage and dialysis status.
N18.6 - End-stage renal disease
Use when CKD stage 5 progresses to ESRD with dialysis.
Applicable To
- CKD stage 5 with chronic dialysis
Clinical Validation Requirements
- Chronic dialysis treatment
- eGFR <15 mL/min/1.73m²
Coding Notes
Transition from N18.5 to N18.6 once dialysis starts.
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 Chronic Kidney Disease Stage 5 to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N18.5.
Impact
Clinical: Inaccurate representation of patient condition, Regulatory: Potential audit findings, Financial: Loss of appropriate reimbursement
Mitigation Strategy
Always document causal conditions, Use combination codes where applicable
Impact
Reimbursement: Incorrect DRG assignment affecting payment, Compliance: Non-compliance with ICD-10 coding rules, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Use only N18.6 if dialysis is initiated.
Impact
Using incorrect codes for CKD stages can lead to audits.
Mitigation Strategy
Ensure accurate documentation of CKD stage and dialysis status.
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 Chronic Kidney Disease Stage 5, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chronic Kidney Disease Stage 5
Use these documentation templates to ensure complete and accurate documentation for Chronic Kidney Disease Stage 5. These templates include all required elements for proper coding and billing.
Nephrology Progress Note
Specialty: NephrologyRequired Elements
- Stage of CKD
- Causal condition
- Dialysis status
- eGFR values
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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