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Home Health ICD-9/ICD-10 Alert

Reader Questions:

Keep Kidney Failure Codes In Check

Published on Mon Nov 26, 2007

Question: How do I know when to list a code for renal insufficiency rather than renal failure? I've been listing 585.9 (Chronic kidney disease, unspecified) for chronic failure and chronic insufficiency, 584.9 (Acute renal failure, unspecified) for acute failure and 593.9 (Unspecified disease of kidney and ureter) for acute insufficiency. Are these the most accurate codes? Also, what do I do if the medical record doesn't specify whether it's acute or chronic?

-- Iowa Subscriber

Answer: Note that chronic kidney disease codes include both insufficiency and failure and the fourth digit indicates the stage of CKD. You may find the stage included in documentation or you can determine it from the glomerular filtration rate (GFR). If your patient is on dialysis, the code is automatically 585.6 (End stage renal disease).

Acute renal disease has separate codes for patients with insufficiency and failure. Without further documentation, acute renal insufficiency is coded 593.9 (Unspecified disorder of kidney and ureter). Acute renal failure without further documentation is coded 584.9 (Acute renal failure, unspecified).If there is no documentation as to acute or chronic, then 593.9 includes renal disease NOS (not otherwise specified). Use code 586 (Renal failure, unspecified) if the patient has renal failure that is unspecified as chronic or acute.

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