ICD-10 Coding for End-Stage Renal Disease on Dialysis(N18.6, Z99.2)
Complete ICD-10-CM coding and documentation guide for End-Stage Renal Disease on Dialysis. 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 on Dialysis
N18.5-N18.6Primary Range
Chronic Kidney Disease Stages 5 and End-Stage Renal Disease
This range includes codes for advanced stages of chronic kidney disease, specifically stage 5 and ESRD, which are relevant for patients requiring dialysis.
Dependence on Renal Dialysis
This code is used to indicate a patient's dependence on dialysis, which is a critical aspect of managing ESRD.
Kidney Transplant Status
This code is relevant for patients who have undergone a kidney transplant, which may occur in the context of 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 ESRD is documented and the patient is on dialysis. |
|
| Z99.2 | Dependence on renal dialysis | Use alongside N18.6 to indicate dialysis dependence. |
|
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 ESRD on dialysis
Essential facts and insights about End-Stage Renal Disease on Dialysis
Primary ICD-10-CM Codes for esrd on dialysis
Decision Criteria
clinical Criteria
- Patient has GFR <15 mL/min and is on dialysis.
Applicable To
- Chronic kidney disease stage 5 requiring dialysis
Excludes
- Acute kidney failure (N17.-)
Clinical Validation Requirements
- GFR <15 mL/min
- Dialysis dependency
- Documentation of ESRD
Code-Specific Risks
- Incorrectly coding for CKD stage 5 without dialysis
Coding Notes
- Ensure documentation specifies ESRD and dialysis dependency.
Z99.2 - Dependence on renal dialysis
Use alongside N18.6 to indicate dialysis dependence.
Applicable To
- Chronic dialysis
Excludes
- Kidney transplant status (Z94.0)
Clinical Validation Requirements
- Documented dialysis schedule
- Dialysis access type
Coding Notes
Ensure dialysis dependency is clearly 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 End-Stage Renal Disease on Dialysis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N18.6.
Impact
Clinical: Misrepresentation of patient's treatment needs., Regulatory: Potential audit risk., Financial: Loss of reimbursement for dialysis services.
Mitigation Strategy
Regularly update dialysis status in patient records, Use standardized templates for dialysis documentation
Impact
Reimbursement: May lead to incorrect DRG assignment and reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate representation of patient's clinical status.
Mitigation Strategy
Always pair N18.6 with Z99.2 to indicate dialysis dependence.
Impact
Incomplete documentation of dialysis dependency.
Mitigation Strategy
Implement regular audits of dialysis documentation.
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 on Dialysis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for End-Stage Renal Disease on Dialysis
Use these documentation templates to ensure complete and accurate documentation for End-Stage Renal Disease on Dialysis. These templates include all required elements for proper coding and billing.
ESRD on Hemodialysis
Specialty: NephrologyRequired Elements
- Dialysis access type
- Dialysis schedule
- GFR and creatinine levels
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for End-Stage Renal Disease on Dialysis? Ask your questions below.