ICD-10 Coding for Acute on Chronic Kidney Injury(N17.9, N18.4)
Complete ICD-10-CM coding and documentation guide for Acute on Chronic Kidney Injury. 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 Kidney Injury
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 kidney injury.
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 injury is present without further specification. |
|
| N18.4 | Chronic kidney disease, stage 4 (severe) | Use to specify stage 4 CKD when 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 kidney injury
Essential facts and insights about Acute on Chronic Kidney Injury
Primary ICD-10-CM Codes for acute on chronic kidney injury
Decision Criteria
clinical Criteria
- Presence of acute kidney injury indicators such as elevated creatinine.
documentation Criteria
- Documentation must specify 'acute on chronic' to use this code.
Applicable To
- Acute renal failure
Excludes
- Chronic kidney disease (N18.-)
Clinical Validation Requirements
- Serum creatinine increase ≥0.3 mg/dL within 48 hours
- Urine output <0.5 mL/kg/h for 6 hours
Code-Specific Risks
- Risk of under-documentation if chronic component is not specified.
Coding Notes
- Ensure both acute and chronic components are documented to avoid unspecified coding.
N18.4 - Chronic kidney disease, stage 4 (severe)
Use to specify stage 4 CKD when documented.
Applicable To
- Severe chronic renal failure
Excludes
- Acute kidney failure (N17.-)
Clinical Validation Requirements
- GFR 15-29 mL/min/1.73 m²
Coding Notes
Ensure CKD stage is documented to avoid unspecified coding.
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 Acute on Chronic Kidney Injury to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N17.9.
Impact
Clinical: Inaccurate representation of patient condition., Regulatory: Non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Ensure documentation includes both acute and chronic aspects., Use templates to guide comprehensive documentation.
Impact
Reimbursement: Incomplete coding may lead to lower reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data representation of patient condition.
Mitigation Strategy
Code N17.9 + N18.6 + Z99.2 to capture both acute and chronic components.
Impact
Risk of audits due to missing documentation of chronic component.
Mitigation Strategy
Use comprehensive templates and ensure all clinical indicators are documented.
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 Kidney Injury, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Acute on Chronic Kidney Injury
Use these documentation templates to ensure complete and accurate documentation for Acute on Chronic Kidney Injury. These templates include all required elements for proper coding and billing.
Acute on chronic kidney injury in a diabetic patient
Specialty: NephrologyRequired Elements
- Patient history including diabetes and CKD
- Current creatinine and baseline levels
- Urine output and other clinical indicators
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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