ICD-10 Coding for Stage 4 Chronic Kidney Disease(N18.4)
Complete ICD-10-CM coding and documentation guide for Stage 4 Chronic Kidney Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Stage 4 Chronic Kidney Disease
N18.1-N18.9Primary Range
Chronic kidney disease (CKD) stages 1-5
This range covers all stages of CKD, with N18.4 specifically for stage 4.
Type 2 diabetes mellitus with kidney complications
Relevant for CKD cases with diabetes as an underlying cause.
Key Information: ICD-10 code for stage 4 chronic kidney disease
Essential facts and insights about Stage 4 Chronic Kidney Disease
Primary ICD-10-CM Code for stage 4 chronic kidney disease
Decision Criteria
clinical Criteria
- eGFR between 15-29 mL/min/1.73m²
documentation Criteria
- Documented as stage 4 CKD
Applicable To
- Severe reduction in kidney function
Excludes
- End stage renal disease (N18.6)
Clinical Validation Requirements
- eGFR 15-29 mL/min/1.73m² for ≥3 months
- Proteinuria ≥300 mg/day or ACR ≥300 mg/g
Code-Specific Risks
- Incorrect staging due to lab-documentation mismatch
Coding Notes
- Ensure documentation supports the stage and underlying conditions.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Type 2 diabetes mellitus with diabetic chronic kidney disease
E11.22Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I12.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Stage 4 Chronic Kidney Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N18.4.
Impact
Clinical: Inaccurate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Always verify and document the CKD stage., Cross-check lab results with documentation.
Impact
Reimbursement: Potential underpayment due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Decreased accuracy in patient records.
Mitigation Strategy
Always code to the highest specificity, such as N18.4 for stage 4.
Impact
Inaccurate documentation of CKD stage can lead to audit issues.
Mitigation Strategy
Regularly review and update documentation practices.
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 Stage 4 Chronic Kidney Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Stage 4 Chronic Kidney Disease
Use these documentation templates to ensure complete and accurate documentation for Stage 4 Chronic Kidney Disease. These templates include all required elements for proper coding and billing.
Nephrology Progress Note
Specialty: NephrologyRequired Elements
- Subjective symptoms
- Objective lab results
- Assessment with stage and etiology
- Plan for management
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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