ICD-10 Coding for Acute-on-Chronic Renal Failure(N17.9, N18.3)
Complete ICD-10-CM coding and documentation guide for Acute-on-Chronic Renal Failure. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Acute-on-Chronic Renal Failure
N17-N19Primary Range
Acute kidney failure and chronic kidney disease
This range includes codes for acute kidney injury (AKI) and chronic kidney disease (CKD), which are essential for coding acute-on-chronic renal failure.
Hypertensive kidney disease
Relevant when acute-on-chronic renal failure is associated with hypertension.
Type 2 diabetes mellitus with diabetic chronic kidney disease
Used when acute-on-chronic renal failure is associated with diabetic kidney disease.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N17.9 | Acute kidney failure, unspecified | Use when acute kidney failure is present without specific etiology documented. |
|
| N18.3 | Chronic kidney disease, stage 3 | Use when CKD stage 3 is documented. |
|
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 acute-on-chronic renal failure
Essential facts and insights about Acute-on-Chronic Renal Failure
Primary ICD-10-CM Codes for acute chronic renal failure
Decision Criteria
clinical Criteria
- Presence of acute renal failure symptoms and lab findings.
Applicable To
- Acute renal failure NOS
Excludes
- Chronic kidney disease (N18.-)
Clinical Validation Requirements
- ≥1.5x baseline creatinine within 7 days
- ≥0.3 mg/dL increase in 48 hours
Code-Specific Risks
- Risk of under-documenting specific causes of AKI.
Coding Notes
- Ensure documentation specifies 'acute-on-chronic' to differentiate from chronic conditions.
N18.3 - Chronic kidney disease, stage 3
Use when CKD stage 3 is documented.
Applicable To
- Moderate CKD
Excludes
- Acute kidney failure (N17.-)
Clinical Validation Requirements
- GFR 30-59 mL/min/1.73m²
Coding Notes
Ensure CKD stage is explicitly 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 Acute-on-Chronic Renal Failure to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N17.9.
Impact
Clinical: Leads to misinterpretation of severity., Regulatory: Non-compliance with documentation standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Educate providers on specific terminology., Use templates that prompt for detailed documentation.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of patient records.
Mitigation Strategy
Ensure documentation specifies the stage of CKD and the cause of AKI.
Impact
Inaccurate staging can lead to audit discrepancies.
Mitigation Strategy
Regular training on CKD staging criteria.
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 Acute-on-Chronic Renal Failure, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Acute-on-Chronic Renal Failure
Use these documentation templates to ensure complete and accurate documentation for Acute-on-Chronic Renal Failure. These templates include all required elements for proper coding and billing.
Acute-on-Chronic Renal Failure in Nephrology
Specialty: NephrologyRequired Elements
- Baseline CKD stage
- Current GFR
- Precipitating factors
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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