# ESRD N18.6 and requiring dialysis Z99.2



## JanetQ (May 12, 2016)

I have always been told that status codes are last Dx codes used, when we bill ESRD, HTN, ANEMIA i would code I12, N18.6, D63.1, Z99.2 this being the status code.  Can someone give me guidance whether this is correct sequencing. I ask this as the code book does say to use additional code with N18.6, but some people are coding I12, N18.6, Z99.2, D63.1.

Thank you


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## mitchellde (May 12, 2016)

Once you have the first listed code correctly placed it does not matter the order of the secondary codes.  Therefore both ways you have listed are correct.


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## taty7479 (Mar 8, 2019)

*Coding esrd & dialysis*

Since patients with ESRD require dialysis to survive, does that mean Z99.2 is automatically added as a 2nd code to N18.6, even if there is no mention whether or not the patient is receiving dialysis? Or does it have to be stated explicitly that the patient is receiving dialysis?


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## arramire (Oct 9, 2019)

If you look at the long descriptor in your ICD 10 CM code book, N18.6 says "Chronic kidney disease requiring chronic dialysis. If they were not on dialysis, they would not be in ESRD. The two go hand in hand... at least that's how I was taught...







Official Long Descriptor
*End stage renal disease*

Chronic kidney disease requiring chronic dialysis


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## shancoughlin (Oct 10, 2019)

We always code D63.1 immediately after the N18 code regardless of where in the order the N18.- is.  We have had denials if the N18 follows the D63.1.


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