ICD-10 Coding for End-Stage Renal Disease (ESRD) Dialysis(N18.6, Z99.2)
Complete ICD-10-CM coding and documentation guide for End-Stage Renal Disease (ESRD) Dialysis. 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 Disease (ESRD) Dialysis
N18.5-N18.6Primary Range
Chronic Kidney Disease, Stage 5 and End-Stage Renal Disease
This range includes codes for the most advanced stages of chronic kidney disease, specifically focusing on ESRD, which requires dialysis.
Dependence on Renal Dialysis
This code is used to indicate a patient's dependence on dialysis, which is essential for ESRD 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 |
|---|---|---|---|
| N18.6 | End-stage renal disease | Use when a patient has initiated dialysis for ESRD. |
|
| Z99.2 | Dependence on renal dialysis | Use with N18.6 to indicate ongoing dialysis dependence. |
|
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 ESRD on dialysis
Essential facts and insights about End-Stage Renal Disease (ESRD) Dialysis
Primary ICD-10-CM Codes for esrd dialysis
Decision Criteria
clinical Criteria
- Patient has started dialysis treatment.
Applicable To
- ESRD on dialysis
Excludes
- Acute renal failure (N17.-)
Clinical Validation Requirements
- eGFR <15 mL/min/1.73m²
- Patient on dialysis
Code-Specific Risks
- Incorrectly using N18.5 once dialysis has started
Coding Notes
- Ensure documentation explicitly states dialysis initiation.
Z99.2 - Dependence on renal dialysis
Use with N18.6 to indicate ongoing dialysis dependence.
Applicable To
- Dialysis dependence
Excludes
- Temporary dialysis (Z79.89)
Clinical Validation Requirements
- Documented dialysis schedule
Coding Notes
Always pair with N18.6 for ESRD patients.
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 Disease (ESRD) Dialysis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N18.6.
Impact
Clinical: Misrepresentation of patient's treatment status, Regulatory: Potential audit issues, Financial: Loss of reimbursement
Mitigation Strategy
Regularly update patient records with dialysis status, Use templates for consistent documentation
Impact
Reimbursement: Incorrect reimbursement due to misclassification, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate patient records
Mitigation Strategy
Confirm dialysis initiation and use N18.6 with Z99.2.
Impact
Failure to document dialysis dependency can lead to audit flags.
Mitigation Strategy
Implement regular audits of patient records to ensure compliance.
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 Disease (ESRD) Dialysis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for End-Stage Renal Disease (ESRD) Dialysis
Use these documentation templates to ensure complete and accurate documentation for End-Stage Renal Disease (ESRD) Dialysis. These templates include all required elements for proper coding and billing.
ESRD Patient on Hemodialysis
Specialty: NephrologyRequired Elements
- Patient's dialysis schedule
- Type of vascular access
- Underlying cause of ESRD
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for End-Stage Renal Disease (ESRD) Dialysis? Ask your questions below.