ICD-10 Coding for End-Stage Renal Disease on Hemodialysis(N18.6, I13.2, E11.22)
Complete ICD-10-CM coding and documentation guide for End-Stage Renal Disease on Hemodialysis. 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 Hemodialysis
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 which requires dialysis.
Hypertensive Chronic Kidney Disease
These codes are 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 the underlying cause 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 the patient is on dialysis due to ESRD. |
|
| I13.2 | Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease | Use when hypertension is the cause of ESRD and heart failure is present. |
|
| E11.22 | Type 2 diabetes mellitus with diabetic chronic kidney disease | Use when diabetes is the primary cause of ESRD. |
|
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 hemodialysis
Essential facts and insights about End-Stage Renal Disease on Hemodialysis
Primary ICD-10-CM Codes for esrd on hemodynamic
Decision Criteria
clinical Criteria
- Patient is on regular dialysis treatment.
Applicable To
- ESRD on dialysis
Excludes
- Chronic kidney disease stage 5 (N18.5)
Clinical Validation Requirements
- eGFR <15 mL/min/1.73m²
- Patient on dialysis
Code-Specific Risks
- Ensure dialysis dependence is documented.
Coding Notes
- Ensure the cause of ESRD is documented and coded if applicable.
I13.2 - Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease
Use when hypertension is the cause of ESRD and heart failure is present.
Applicable To
- Hypertensive heart and CKD with ESRD
Excludes
- Hypertensive heart disease without CKD (I11.-)
Clinical Validation Requirements
- Diagnosis of hypertension with heart failure and ESRD
Coding Notes
Sequence this code first if hypertension is the primary cause.
E11.22 - Type 2 diabetes mellitus with diabetic chronic kidney disease
Use when diabetes is the primary cause of ESRD.
Applicable To
- Diabetes with CKD leading to ESRD
Excludes
- Diabetes without CKD (E11.9)
Clinical Validation Requirements
- Diagnosis of diabetes with ESRD
Coding Notes
Sequence this code first if diabetes is the primary cause.
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 End-Stage Renal Disease on Hemodialysis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N18.6.
Impact
Clinical: Potential mismanagement of patient care., Regulatory: Non-compliance with documentation standards., Financial: Claims may be denied or delayed.
Mitigation Strategy
Use specific terminology like 'ESRD'., Ensure documentation reflects dialysis status.
Impact
Reimbursement: Incorrect DRG assignment leading to potential underpayment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient data and statistics.
Mitigation Strategy
Always use N18.6 when the patient is on dialysis.
Impact
Reimbursement: Potential denial of claims due to incomplete coding., Compliance: Failure to meet coding standards., Data Quality: Incomplete patient treatment records.
Mitigation Strategy
Always include Z99.2 to indicate dialysis dependence.
Impact
Failure to document dialysis details can lead to audit issues.
Mitigation Strategy
Ensure all dialysis details are documented in patient records.
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 Hemodialysis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for End-Stage Renal Disease on Hemodialysis
Use these documentation templates to ensure complete and accurate documentation for End-Stage Renal Disease on Hemodialysis. These templates include all required elements for proper coding and billing.
Nephrology Consult for ESRD
Specialty: NephrologyRequired Elements
- Diagnosis of ESRD
- Dialysis details
- Cause of ESRD
- Comorbid conditions
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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