ICD-10 Coding for Low Glomerular Filtration Rate(N18.1, N18.6)
Complete ICD-10-CM coding and documentation guide for Low Glomerular Filtration Rate. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Low Glomerular Filtration Rate
N18.1-N18.9Primary Range
Chronic kidney disease (CKD) stages 1–5, unspecified, or end-stage renal disease (ESRD)
This range includes codes for various stages of CKD, which are directly related to low GFR.
Abnormal results of kidney function studies
Used for abnormal GFR results without a CKD diagnosis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N18.1 | Chronic kidney disease, stage 1 | Use when CKD stage 1 is documented with GFR ≥90. |
|
| N18.6 | End-stage renal disease | Use when ESRD is documented and patient requires dialysis. |
|
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 low GFR
Essential facts and insights about Low Glomerular Filtration Rate
Primary ICD-10-CM Codes for low glomerular filtration rate
Decision Criteria
clinical Criteria
- GFR ≥90 with evidence of kidney damage
Applicable To
- GFR 90 or greater
Excludes
- Acute kidney failure (N17.-)
Clinical Validation Requirements
- GFR ≥90 mL/min/1.73 m² for ≥3 months with kidney damage
Code-Specific Risks
- Misclassification if GFR is not consistently ≥90.
Coding Notes
- Ensure CKD stage is documented explicitly.
N18.6 - End-stage renal disease
Use when ESRD is documented and patient requires dialysis.
Applicable To
- CKD requiring dialysis
Excludes
- Acute kidney failure (N17.-)
Clinical Validation Requirements
- Documentation of ESRD and dialysis requirement
Coding Notes
Ensure ESRD is explicitly documented.
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 Low Glomerular Filtration Rate to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N18.1.
Impact
Clinical: Misrepresentation of patient's condition., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Verify dialysis requirement before coding.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Always confirm CKD stage with provider documentation.
Impact
Inadequate documentation of CKD stages.
Mitigation Strategy
Implement regular documentation audits.
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 Low Glomerular Filtration Rate, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Low Glomerular Filtration Rate
Use these documentation templates to ensure complete and accurate documentation for Low Glomerular Filtration Rate. These templates include all required elements for proper coding and billing.
CKD with Diabetes
Specialty: NephrologyRequired Elements
- CKD stage
- GFR value
- Diabetes status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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