ICD-10 Coding for Chronic Renal Insufficiency(N18.1, N18.6)
Complete ICD-10-CM coding and documentation guide for Chronic Renal Insufficiency. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Chronic Renal Insufficiency
N18.1-N18.6Primary Range
Chronic kidney disease (CKD) stages 1-5 and end-stage renal disease (ESRD)
This range covers the stages of chronic kidney disease, which are crucial for accurate diagnosis and treatment planning.
Other specified disorders of kidney and ureter
Used when CKD is unspecified or not clearly documented.
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 eGFR is ≥ 90 and there is evidence of kidney damage. |
|
| N18.6 | End stage renal disease | Use when eGFR is < 15 and the patient is on dialysis or has a transplant. |
|
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 insufficiency
Essential facts and insights about Chronic Renal Insufficiency
Primary ICD-10-CM Codes for chronic renal insufficiency
Decision Criteria
clinical Criteria
- eGFR ≥ 90 with kidney damage
Applicable To
- CKD stage 1
Excludes
- Acute kidney failure (N17.-)
Clinical Validation Requirements
- eGFR ≥ 90 with evidence of kidney damage
Code-Specific Risks
- Misclassification if eGFR is not accurately measured.
Coding Notes
- Ensure chronicity is documented with eGFR values over time.
N18.6 - End stage renal disease
Use when eGFR is < 15 and the patient is on dialysis or has a transplant.
Applicable To
- ESRD
Excludes
- Acute kidney failure (N17.-)
Clinical Validation Requirements
- eGFR < 15
- Dialysis or transplant status
Coding Notes
Ensure dialysis or transplant status is documented.
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 Renal Insufficiency 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 staging of CKD., Regulatory: Non-compliance with coding guidelines., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Regularly update lab results in patient records.
Impact
Reimbursement: May result in lower reimbursement rates., Compliance: Non-compliance with specificity requirements., Data Quality: Decreases accuracy of patient records.
Mitigation Strategy
Query for specific CKD stage documentation.
Impact
Risk of audits due to unspecified CKD stages.
Mitigation Strategy
Ensure all CKD documentation specifies the stage and underlying cause.
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 Insufficiency, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chronic Renal Insufficiency
Use these documentation templates to ensure complete and accurate documentation for Chronic Renal Insufficiency. These templates include all required elements for proper coding and billing.
Nephrology Progress Note
Specialty: NephrologyRequired Elements
- Subjective symptoms
- Objective findings
- Assessment
- Plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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