# Acute on Chronic - How many of you code



## Gemini18 (Aug 20, 2009)

How many of you code to "chronic" when you see a diagnosis of --

*Acute on chronic renal failure?*


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## heatherwinters (Aug 20, 2009)

*Renal Failure*

Take a look at this article
http://www.fortherecordmag.com/archives/ftr_05122008p31.shtml


> *Acute Renal Failure With Chronic Renal   Failure*
> Occasionally, medical record documentation may state the patient was admitted with acute-on-chronic renal failure, meaning there was an exacerbation of the chronic status, which may have been indicated by a rise in the creatinine level. Another condition such as dehydration may have caused the exacerbation. In this case, it is appropriate to assign a code for both the acute renal failure (584.9) and chronic renal failure (585.9).


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## Gemini18 (Aug 20, 2009)

Thanks Heather


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## heatherwinters (Aug 20, 2009)

*Article*

No problem, hope it helps


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## pkidd (Aug 25, 2009)

Gemini18 said:


> How many of you code to "chronic" when you see a diagnosis of --
> 
> *Acute on chronic renal failure?*


Hi,
We always code the ESRD/CKD in addition to any acute renal failure.  Try to be as specific as possible when coding CKD.   If your MD does not provide the level of CKD, look for the most recent lab study of MORD GFR.   The result will guide you to the appropriate code.  (Yeah... I code this a lot!)
Hope this is helpful!
pat

_______________
_Pat Kidd, CPC_


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## mitchellde (Aug 25, 2009)

Also if you look to the guidelines for coding and reporting of ICD-9 it states to code both the acut and the chronic and to sequnce first the one being treated.


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