ICD-10 Coding for Chronic Kidney Disease(N18.1, N18.6)
Complete ICD-10-CM coding and documentation guide for Chronic Kidney Disease. 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
N18.1-N18.9Primary Range
Chronic Kidney Disease stages 1-5 and unspecified
This range covers the various stages of CKD, which are critical for accurate diagnosis and treatment planning.
Diabetic Chronic Kidney Disease
These codes are used when CKD is a complication of diabetes, requiring specific sequencing.
Hypertensive Chronic Kidney Disease
These codes apply when CKD is associated with hypertension, necessitating combined coding.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N18.1 | Chronic kidney disease, stage 1 | Use when CKD is diagnosed with a GFR of 90 or greater. |
|
| N18.6 | End stage renal disease | Use when CKD has progressed 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: ICD-10 code for CKD stage 3
Essential facts and insights about Chronic Kidney Disease
Primary ICD-10-CM Codes for chronic kidney disease
Decision Criteria
clinical Criteria
- GFR ≥90 mL/min/1.73m² for ≥3 months
Applicable To
- CKD with GFR 90 or greater
Excludes
- Acute kidney failure (N17.-)
Clinical Validation Requirements
- eGFR ≥90 mL/min/1.73m² for ≥3 months
Code-Specific Risks
- Misclassification if GFR is not consistently ≥90.
Coding Notes
- Ensure GFR is consistently ≥90 for accurate coding.
N18.6 - End stage renal disease
Use when CKD has progressed to ESRD with dialysis.
Applicable To
- ESRD on dialysis
Excludes
- Acute kidney failure (N17.-)
Clinical Validation Requirements
- eGFR <15 mL/min/1.73m² and dialysis dependence
Coding Notes
Ensure documentation of dialysis for accurate coding.
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 to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N18.1.
Impact
Clinical: Inaccurate treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential loss of reimbursement.
Mitigation Strategy
Query providers for clarification., Ensure documentation links diabetes to CKD.
Impact
Reimbursement: Incorrect coding may lead to lower reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient data affecting treatment plans.
Mitigation Strategy
Use N18.6 for ESRD when dialysis is documented.
Impact
Misclassification of CKD stages can lead to audit findings.
Mitigation Strategy
Ensure accurate and consistent documentation of eGFR.
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, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chronic Kidney Disease
Use these documentation templates to ensure complete and accurate documentation for Chronic Kidney Disease. These templates include all required elements for proper coding and billing.
CKD with Hypertension
Specialty: NephrologyRequired Elements
- Blood pressure readings
- eGFR values
- Medication list
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Chronic Kidney Disease? Ask your questions below.