ICD-10 Coding for Microalbuminuria(R80.0, E11.21)
Complete ICD-10-CM coding and documentation guide for Microalbuminuria. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Microalbuminuria
Abnormal findings on examination of urine, without diagnosis
Includes codes for proteinuria and microalbuminuria without specific underlying conditions.
E11-E14Primary Range
Diabetes mellitus
Includes codes for diabetes with renal complications, such as microalbuminuria.
Chronic kidney disease (CKD)
Includes codes for CKD stages, often used in conjunction with diabetes codes.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R80.0 | Isolated proteinuria with specified cause | Use when microalbuminuria is present without diabetes or CKD. |
|
| E11.21 | Type 2 diabetes mellitus with diabetic nephropathy | Use when microalbuminuria is present in a patient with diabetes. |
|
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 microalbuminuria
Essential facts and insights about Microalbuminuria
Primary ICD-10-CM Codes for microalbuminuria
Decision Criteria
clinical Criteria
- ACR 30-299 mg/g without diabetes
Applicable To
- Microalbuminuria without diabetes
Excludes
- Diabetic nephropathy (E11.21)
Clinical Validation Requirements
- ACR 30-299 mg/g on two separate occasions
Code-Specific Risks
- Misclassification if diabetes is present
Coding Notes
- Ensure no diabetes is documented when using this code.
E11.21 - Type 2 diabetes mellitus with diabetic nephropathy
Use when microalbuminuria is present in a patient with diabetes.
Applicable To
- Diabetic nephropathy with microalbuminuria
Excludes
- Hypertensive nephropathy (I12.9)
Clinical Validation Requirements
- Diabetes diagnosis
- ACR ≥30 mg/g
- CKD stage documentation
Coding Notes
Sequence diabetes code before CKD code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Chronic kidney disease, stage 3
N18.3Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Microalbuminuria to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R80.0.
Impact
Clinical: Misdiagnosis of nephropathy cause., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Review diabetes status before coding.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate patient records and data reporting.
Mitigation Strategy
Ensure diabetes is documented and use E11.21 for diabetic nephropathy.
Impact
Failure to sequence diabetes before CKD codes.
Mitigation Strategy
Regular training on ICD-10 sequencing rules.
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 Microalbuminuria, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Microalbuminuria
Use these documentation templates to ensure complete and accurate documentation for Microalbuminuria. These templates include all required elements for proper coding and billing.
Diabetic patient with microalbuminuria
Specialty: NephrologyRequired Elements
- ACR values
- CKD stage
- Diabetes type
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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