ICD-10 Coding for Chronic Renal Failure(N18.1, N18.6)
Complete ICD-10-CM coding and documentation guide for Chronic Renal Failure. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Chronic Renal Failure
N18.1-N18.6Primary Range
Chronic Kidney Disease stages 1-5 and End Stage Renal Disease
This range covers all stages of chronic kidney disease, including end-stage renal disease, which is critical for accurate diagnosis and treatment planning.
Dependence on renal dialysis
Used to indicate a patient's dependence on dialysis, which is crucial for treatment and billing purposes.
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 with appropriate GFR and kidney damage evidence. |
|
| N18.6 | End stage renal disease | Use when ESRD is documented and patient is 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 chronic renal failure
Essential facts and insights about Chronic Renal Failure
Primary ICD-10-CM Codes for chronic renal failure
Decision Criteria
clinical Criteria
- GFR ≥ 90 with kidney damage
Applicable To
- GFR ≥ 90 with evidence of kidney damage
Excludes
- Acute kidney failure (N17.-)
Clinical Validation Requirements
- GFR ≥ 90 with evidence of kidney damage for at least 3 months
Code-Specific Risks
- Misclassification if GFR is not consistently ≥ 90
Coding Notes
- Ensure documentation specifies kidney damage evidence.
N18.6 - End stage renal disease
Use when ESRD is documented and patient is on dialysis.
Applicable To
- Chronic kidney disease stage 5 with dialysis
Excludes
- Acute kidney failure (N17.-)
Clinical Validation Requirements
- GFR < 15 or dialysis dependence
Coding Notes
Ensure dialysis status is clearly documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Chronic Renal Failure 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 planning., Regulatory: Non-compliance with coding standards., Financial: Loss of dialysis-related reimbursement.
Mitigation Strategy
Always verify and document dialysis status, Use Z99.2 when applicable
Impact
Reimbursement: Potential loss of HCC-related reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreased accuracy in patient records.
Mitigation Strategy
Query for specific stage and use appropriate N18.x code.
Impact
Using N18.9 without specific stage documentation.
Mitigation Strategy
Implement mandatory stage documentation protocols.
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 Failure, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chronic Renal Failure
Use these documentation templates to ensure complete and accurate documentation for Chronic Renal Failure. These templates include all required elements for proper coding and billing.
CKD stage 3b with hypertension
Specialty: NephrologyRequired Elements
- Stage and GFR
- Etiology
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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