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ICD-10 Coding for Acute Renal Failure(N17.0, N17.2, N17.9)

Complete ICD-10-CM coding and documentation guide for Acute Renal Failure. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Acute Kidney InjuryARFAKI

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Related ICD-10 Code Ranges

Complete code families applicable to Acute Renal Failure

N17-N19Primary Range

Acute kidney failure and chronic kidney disease

This range includes codes for acute kidney failure, which is the primary focus for acute renal failure/acute kidney injury.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
N17.0Acute kidney failure with tubular necrosisUse when acute tubular necrosis is documented with supporting lab findings.
  • Presence of granular casts in urine
  • Rise in serum creatinine from baseline
N17.2Acute kidney failure with medullary necrosisUse when medullary necrosis is documented with supporting imaging findings.
  • Imaging findings supporting medullary necrosis
  • Rise in serum creatinine from baseline
N17.9Acute kidney failure, unspecifiedUse when acute kidney failure is documented without further specification.
  • Rise in serum creatinine by ≥0.3 mg/dL within 48 hours
  • Oliguria <0.5 mL/kg/hour for at least six hours

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 renal failure

Essential facts and insights about Acute Renal Failure

The ICD-10 code for acute renal failure is N17.9 when unspecified. For specific types, use N17.0 for acute tubular necrosis and N17.2 for medullary necrosis.

Primary ICD-10-CM Codes for acute renal failure

N17.0
Acute kidney failure with tubular necrosis
Billable Code

Decision Criteria

clinical Criteria

  • Documented presence of granular casts and rise in serum creatinine

Applicable To

  • Acute tubular necrosis

Excludes

  • Chronic kidney disease (N18.-)

Clinical Validation Requirements

  • Presence of granular casts in urine
  • Rise in serum creatinine from baseline

Code-Specific Risks

  • Misclassification if granular casts are not documented

Coding Notes

  • Ensure documentation specifies 'acute tubular necrosis' with lab evidence.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Dehydration

E86.0
Use when dehydration is the underlying cause of AKI.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Acute kidney failure, unspecified

N17.9
Use N17.9 when no specific type of acute kidney failure is documented.

Acute kidney failure with tubular necrosis

N17.0
Use N17.0 when tubular necrosis is specifically documented.

Acute kidney failure with medullary necrosis

N17.2
Use N17.2 when medullary necrosis is specifically documented.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Acute Renal Failure to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N17.0.

Impact

Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Increases risk of audit and non-compliance., Financial: Potential for reduced reimbursement.

Mitigation Strategy

Ensure documentation includes specific lab values and clinical indicators, Use precise medical terminology

Impact

Reimbursement: Incorrect coding may lead to lower reimbursement., Compliance: Non-specific documentation can trigger audits., Data Quality: Impacts accuracy of patient records.

Mitigation Strategy

Query physicians to specify if 'renal failure' is acute or chronic.

Impact

Reimbursement: May result in claim denials., Compliance: Fails to meet coding guidelines., Data Quality: Reduces reliability of clinical data.

Mitigation Strategy

Ensure documentation includes specific lab comparisons.

Impact

Lack of specific documentation can trigger audits.

Mitigation Strategy

Ensure documentation includes specific lab values and clinical indicators.

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 Renal Failure, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Acute Renal Failure

Use these documentation templates to ensure complete and accurate documentation for Acute Renal Failure. These templates include all required elements for proper coding and billing.

Acute Kidney Injury due to Dehydration

Specialty: Nephrology

Required Elements

  • Chief Complaint
  • History of Present Illness
  • Vital Signs
  • Lab Results
  • Assessment
  • Plan

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has kidney failure and is being treated with IV fluids.
Good Documentation Example
Patient presents with acute kidney injury, evidenced by a rise in serum creatinine from 1.1 mg/dL to 2.2 mg/dL within 48 hours and oliguria (<0.5 mL/kg/hour for >6 hours). The clinical picture, supported by urinalysis showing granular casts, is consistent with acute tubular necrosis secondary to dehydration. Patient is treated with IV fluids with planned serial monitoring of renal function.
Explanation
The good example provides specific lab values, time frames, and clinical indicators, meeting documentation requirements for AKI.

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