ICD-10 Coding for Chronic Renal Disease(N18.1, N18.2, N18.3, N18.4, N18.5, N18.6)
Complete ICD-10-CM coding and documentation guide for Chronic Renal Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Chronic Renal Disease
N18.1-N18.9Primary Range
Chronic kidney disease stages 1-5 and unspecified
This range covers all stages of chronic kidney disease, which is the primary focus for coding chronic renal disease.
Hypertensive chronic kidney disease
These codes are used when CKD is due to hypertension, requiring sequencing before CKD stage codes.
Type 2 diabetes mellitus with diabetic chronic kidney disease
This code is used when CKD is due to diabetes, requiring sequencing before CKD stage codes.
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 stage 1 is documented by the provider. |
|
| N18.2 | Chronic kidney disease, stage 2 (mild) | Use when CKD stage 2 is documented by the provider. |
|
| N18.3 | Chronic kidney disease, stage 3 | Use when CKD stage 3 is documented by the provider. |
|
| N18.4 | Chronic kidney disease, stage 4 (severe) | Use when CKD stage 4 is documented by the provider. |
|
| N18.5 | Chronic kidney disease, stage 5 | Use when CKD stage 5 is documented by the provider. |
|
| N18.6 | End stage renal disease | Use when ESRD is documented by the provider. |
|
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 chronic renal disease
Essential facts and insights about Chronic Renal Disease
Primary ICD-10-CM Codes for chronic renal disease
Decision Criteria
clinical Criteria
- eGFR 90 or greater with evidence of kidney damage
Applicable To
- CKD stage 1
Excludes
- Acute kidney failure
Clinical Validation Requirements
- eGFR 90 or greater with kidney damage
Code-Specific Risks
- Incorrect staging without provider documentation.
Coding Notes
- Ensure provider documents specific stage.
N18.2 - Chronic kidney disease, stage 2 (mild)
Use when CKD stage 2 is documented by the provider.
Applicable To
- CKD stage 2
Excludes
- Acute kidney failure
Clinical Validation Requirements
- eGFR 60-89 with kidney damage
Coding Notes
Ensure provider documents specific stage.
N18.3 - Chronic kidney disease, stage 3
Use when CKD stage 3 is documented by the provider.
Applicable To
- CKD stage 3
Excludes
- Acute kidney failure
Clinical Validation Requirements
- eGFR 30-59
Coding Notes
Ensure provider documents specific stage.
N18.4 - Chronic kidney disease, stage 4 (severe)
Use when CKD stage 4 is documented by the provider.
Applicable To
- CKD stage 4
Excludes
- Acute kidney failure
Clinical Validation Requirements
- eGFR 15-29
Coding Notes
Ensure provider documents specific stage.
N18.5 - Chronic kidney disease, stage 5
Use when CKD stage 5 is documented by the provider.
Applicable To
- CKD stage 5
Excludes
- Acute kidney failure
Clinical Validation Requirements
- eGFR less than 15
Coding Notes
Ensure provider documents specific stage.
N18.6 - End stage renal disease
Use when ESRD is documented by the provider.
Applicable To
- ESRD
Excludes
- Acute kidney failure
Clinical Validation Requirements
- eGFR less than 15 with dialysis
Coding Notes
Ensure provider documents ESRD and dialysis status.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Chronic Renal 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: Leads to vague clinical records., Regulatory: Non-compliance with documentation standards., Financial: Potential for incorrect coding and reimbursement.
Mitigation Strategy
Educate providers on CKD staging, Use templates with specific staging prompts
Impact
Reimbursement: May lead to incorrect DRG assignment and reimbursement., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Decreases accuracy of patient records.
Mitigation Strategy
Always use the most specific CKD stage code documented by the provider.
Impact
Reimbursement: Incorrect reimbursement due to inappropriate ESRD coding., Compliance: Non-compliance with coding standards., Data Quality: Misrepresentation of patient's clinical status.
Mitigation Strategy
Ensure dialysis is documented before coding ESRD.
Impact
Incorrect staging due to lack of provider documentation.
Mitigation Strategy
Implement mandatory staging documentation in EHR.
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 Renal Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chronic Renal Disease
Use these documentation templates to ensure complete and accurate documentation for Chronic Renal Disease. These templates include all required elements for proper coding and billing.
Nephrology Progress Note
Specialty: NephrologyRequired Elements
- CKD stage
- Underlying cause
- Dialysis status
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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