ICD-10 Coding for Kidney Problems(I12.0, N18.3)
Complete ICD-10-CM coding and documentation guide for Kidney Problems. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Kidney Problems
I12-I13Primary Range
Hypertensive diseases with chronic kidney disease
This range includes codes for hypertensive kidney disease, which is a common cause of chronic kidney disease.
N18Primary Range
Chronic kidney disease (CKD)
This range is used to classify the stages of chronic kidney disease, which is critical for accurate diagnosis and treatment.
Acute kidney failure
This range covers acute kidney injury, which requires different management and coding than chronic conditions.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I12.0 | Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease | Use when hypertension is documented with CKD stage 5 or ESRD. |
|
| N18.3 | Chronic kidney disease, stage 3 | Use when CKD stage 3 is documented with eGFR between 30-59. |
|
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 kidney disease
Essential facts and insights about Kidney Problems
Primary ICD-10-CM Codes for kidney problems
Decision Criteria
clinical Criteria
- Presence of hypertension and CKD stage 5 or ESRD
Applicable To
- Hypertensive CKD stage 5
- Hypertensive ESRD
Excludes
- Hypertensive heart and CKD (I13.-)
Clinical Validation Requirements
- Documented hypertension
- CKD stage 5 or ESRD
Code-Specific Risks
- Incorrect staging of CKD
- Missing documentation of hypertension
Coding Notes
- Ensure accurate documentation of both hypertension and CKD stage.
N18.3 - Chronic kidney disease, stage 3
Use when CKD stage 3 is documented with eGFR between 30-59.
Applicable To
- Moderate CKD
Excludes
- Acute kidney failure (N17.-)
Clinical Validation Requirements
- eGFR 30-59 on two separate occasions
Coding Notes
Ensure eGFR is documented to support CKD stage.
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 Kidney Problems to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I12.0.
Impact
Clinical: Impacts treatment decisions., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Always document eGFR, Specify CKD stage
Impact
Reimbursement: Incorrect sequencing can lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use combination codes like I12.0 when hypertension and CKD coexist.
Impact
Incorrect CKD stage documentation can lead to audit findings.
Mitigation Strategy
Regular training on CKD staging and documentation.
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 Kidney Problems, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Kidney Problems
Use these documentation templates to ensure complete and accurate documentation for Kidney Problems. These templates include all required elements for proper coding and billing.
Chronic kidney disease management
Specialty: NephrologyRequired Elements
- CKD stage
- eGFR values
- Hypertension status
- Dialysis status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Kidney Problems? Ask your questions below.