ICD-10 Coding for Diabetes with Kidney Disease(E11.22, N18.4)
Complete ICD-10-CM coding and documentation guide for Diabetes with Kidney Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diabetes with Kidney Disease
E08-E13Primary Range
Diabetes mellitus
This range includes codes for diabetes mellitus with various complications, including kidney disease.
Chronic kidney disease (CKD)
This range includes codes for staging chronic kidney disease, which is often a complication of diabetes.
Hypertensive diseases
This range includes codes for hypertension, which can co-occur with diabetes and CKD.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E11.22 | Type 2 diabetes mellitus with diabetic chronic kidney disease | Use when CKD is a complication of type 2 diabetes and is documented as such. |
|
| N18.4 | Chronic kidney disease, stage 4 (severe) | Use when CKD is documented as stage 4. |
|
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 diabetes with kidney disease
Essential facts and insights about Diabetes with Kidney Disease
Primary ICD-10-CM Codes for diabetes with kidney disease
Decision Criteria
clinical Criteria
- Presence of CKD with documented diabetes.
documentation Criteria
- Explicit documentation linking CKD to diabetes.
Applicable To
- Diabetic nephropathy
Excludes
- Acute kidney failure (N17.-)
Clinical Validation Requirements
- eGFR <60 mL/min/1.73m²
- Albuminuria ≥30 mg/g
Code-Specific Risks
- Failure to document the linkage between diabetes and CKD.
Coding Notes
- Ensure documentation explicitly links CKD to diabetes.
N18.4 - Chronic kidney disease, stage 4 (severe)
Use when CKD is documented as stage 4.
Applicable To
- Severe CKD
Excludes
- End stage renal disease (N18.6)
Clinical Validation Requirements
- eGFR 15-29 mL/min/1.73m²
Coding Notes
Ensure eGFR values support the stage of CKD.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 Diabetes with Kidney Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.22.
Impact
Clinical: Leads to incomplete clinical records., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Always specify the cause of CKD in documentation., Use templates to ensure completeness.
Impact
Reimbursement: May lead to incorrect coding and affect reimbursement., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Reduces accuracy of patient records.
Mitigation Strategy
Ensure documentation explicitly states CKD is due to diabetes.
Impact
Failure to document CKD as a complication of diabetes can lead to audits.
Mitigation Strategy
Ensure all documentation explicitly links CKD to diabetes.
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 Diabetes with Kidney Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diabetes with Kidney Disease
Use these documentation templates to ensure complete and accurate documentation for Diabetes with Kidney Disease. These templates include all required elements for proper coding and billing.
Diabetes with CKD Stage 3
Specialty: NephrologyRequired Elements
- Diagnosis of diabetes and CKD
- Stage of CKD
- eGFR and albuminuria levels
- Linkage to diabetes
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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