ICD-10 Coding for End Stage Renal Failure(N18.6, Z99.2)
Complete ICD-10-CM coding and documentation guide for End Stage Renal Failure. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to End Stage Renal Failure
N18.5-N18.6Primary Range
Chronic Kidney Disease, Stage 5 and End Stage Renal Disease
This range includes the codes for the most advanced stages of chronic kidney disease, specifically focusing on ESRD which requires chronic dialysis or transplant failure.
Dependence on Renal Dialysis
This code is used to indicate a patient's dependence on dialysis, which is a critical aspect of managing ESRD.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N18.6 | End Stage Renal Disease | Use when the patient is diagnosed with ESRD and requires chronic dialysis or has a failed transplant. |
|
| Z99.2 | Dependence on Renal Dialysis | Use when the patient is dependent on dialysis, typically in conjunction with N18.6. |
|
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 end stage renal failure
Essential facts and insights about End Stage Renal Failure
Primary ICD-10-CM Codes for end stage renal failure
Decision Criteria
clinical Criteria
- Patient requires chronic dialysis or has a failed transplant.
documentation Criteria
- Explicit mention of 'end-stage renal disease' or 'ESRD' in medical records.
Applicable To
- Chronic kidney disease requiring chronic dialysis
Excludes
- Acute kidney failure (N17.-)
Clinical Validation Requirements
- GFR <15 mL/min
- Chronic dialysis documentation
- Transplant failure
Code-Specific Risks
- Incorrectly coding as N18.9 when dialysis is present
Coding Notes
- Ensure explicit documentation of ESRD and dialysis status.
Z99.2 - Dependence on Renal Dialysis
Use when the patient is dependent on dialysis, typically in conjunction with N18.6.
Applicable To
- Chronic dialysis
Clinical Validation Requirements
- Documentation of ongoing dialysis treatment
Coding Notes
This code supports the primary diagnosis of ESRD by indicating dialysis dependence.
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 End Stage Renal Failure to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N18.6.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials or reduced reimbursement.
Mitigation Strategy
Use specific terms like 'ESRD' or 'chronic dialysis'., Regularly update documentation templates.
Impact
Reimbursement: Incorrect coding can lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate representation of patient condition in medical records.
Mitigation Strategy
Ensure N18.6 is used when chronic dialysis is documented.
Impact
Lack of detailed dialysis documentation can trigger audits.
Mitigation Strategy
Ensure comprehensive documentation of dialysis sessions and access type.
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 End Stage Renal Failure, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for End Stage Renal Failure
Use these documentation templates to ensure complete and accurate documentation for End Stage Renal Failure. These templates include all required elements for proper coding and billing.
ESRD with Diabetes
Specialty: NephrologyRequired Elements
- Diagnosis of ESRD
- Etiology (e.g., diabetes)
- Dialysis details
- Lab results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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