ICD-10 Coding for End-Stage Renal Disease(N18.6, Z99.2)
Complete ICD-10-CM coding and documentation guide for End-Stage Renal Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to End-Stage Renal Disease
N18.5-N18.6Primary Range
Chronic Kidney Disease, Stage 5 and End-Stage Renal Disease
This range includes codes for the most advanced stages of chronic kidney disease, specifically focusing on ESRD.
Dependence on renal dialysis
This code is used to indicate a patient's dependence on dialysis, which is common in ESRD cases.
Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end-stage renal disease
This code is used when hypertension is a contributing factor to ESRD.
Type 2 diabetes mellitus with diabetic chronic kidney disease
This code is used when diabetes is a contributing factor to ESRD.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N18.6 | End-stage renal disease | Use when the patient is diagnosed with ESRD and requires dialysis. |
|
| Z99.2 | Dependence on renal dialysis | Use when the patient is dependent on dialysis as part of ESRD management. |
|
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 end-stage renal disease
Essential facts and insights about End-Stage Renal Disease
Primary ICD-10-CM Codes for end-stage renal disease
Decision Criteria
clinical Criteria
- Patient has GFR <15 mL/min/1.73m² and is on dialysis.
documentation Criteria
- Ensure documentation specifies ESRD and dialysis dependence.
Applicable To
- Chronic kidney disease stage 5 requiring dialysis
Excludes
- Acute kidney failure (N17.-)
Clinical Validation Requirements
- GFR <15 mL/min/1.73m²
- Documentation of dialysis dependence
- Clinical symptoms such as fatigue, edema, uremia
Code-Specific Risks
- Ensure chronicity is documented to avoid confusion with acute renal failure.
Coding Notes
- Always verify the stage of CKD and document any underlying conditions contributing to ESRD.
Z99.2 - Dependence on renal dialysis
Use when the patient is dependent on dialysis as part of ESRD management.
Applicable To
- Chronic dialysis
Excludes
- Temporary dialysis (Z79.89)
Clinical Validation Requirements
- Documentation of regular dialysis sessions
- Clinical notes indicating chronic dialysis requirement
Coding Notes
This code should always accompany N18.6 when dialysis is part of the treatment plan.
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 End-Stage Renal Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N18.6.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential loss of reimbursement for dialysis services.
Mitigation Strategy
Ensure dialysis is documented in every patient encounter., Use templates that prompt for dialysis status.
Impact
Reimbursement: Incorrect coding can lead to lower reimbursement rates., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate data on patient health records.
Mitigation Strategy
Clarify if the condition is chronic and specify the stage.
Impact
Misstaging CKD can lead to incorrect coding and billing.
Mitigation Strategy
Regular training on CKD staging and documentation requirements.
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 End-Stage Renal Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for End-Stage Renal Disease
Use these documentation templates to ensure complete and accurate documentation for End-Stage Renal Disease. These templates include all required elements for proper coding and billing.
Nephrology consult for ESRD management
Specialty: NephrologyRequired Elements
- Patient history
- Current dialysis regimen
- GFR and lab results
- Comorbid conditions
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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