# Hypertensive Acute Renal Failure



## Rachels (Feb 26, 2014)

I need a little help here. How would you code hypertensive acute renal failure? I know if you look at the 403 codes and acute renal failure is under the excludes tab. 

I know hypertension and kidney disease assume a relationship but how about acute renal failure? 

Thanks!


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## burgster95 (Feb 26, 2014)

*Reply to hypertensive acute renal failure*

I logged on to the Kidney Foundation and it states that it should be coded as 403  tabular list (hypertensive kidney disease) then add additional code 585.1-585.6 (if known). Hope that helps. Its on www.kidney.org


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## chaitaligoswami1 (Feb 27, 2014)

Hi,

Category 403 does not include acute kidney failure, which is an entirely different condition from chronic kidney disease. Hence this should be coded as: 584.9 and 401.9

Hope this helps.


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## Rachels (Feb 27, 2014)

Okay! I have been told two different things. My manager told me I need to code 40390 w/5849, but then I don't understand why since 5849 is in the excludes tab under 403 code. 

Thanks for your replies!


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## mitchellde (Feb 27, 2014)

hypertension with acute renal failure is not a 403 code it is a 401.9 with the 584.9, the excludes note means that you cannot code the 403 with the 584.9.  to state that the HTN is the causal condition for the acute renal failure is coded the same as any other underlying condition with a manifestation, that is code the underlying condition first (401.9) and code the manifestation second (584.9).


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## tharal (Feb 27, 2014)

I aslo code both separately 401.9 and 584.9 since 403 category can be used only with chronic kidney disease.

Thara L CPC H


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## Narvaez6 (Mar 12, 2014)

It's in the exclusion note because that is how ICD-9 classified these conditions when together.


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