Home Health ICD-9/ICD-10 Alert

Question: I frequently use code 585 (Chronic renal failure), but heard that this code soon will be eliminated. Is that true? If so, what are we supposed to do when that happens?

Answer: Technically, the 585 code will not be eliminated, but it will become invalid as a three-digit code. As of Oct. 1, 2005, coders will have to select a fourth digit when using 585. This fourth digit will identify the stage of chronic kidney disease.
 The new 585 series will be as follows:
 
585.1 (Chronic kidney disease, Stage I)

585.2 (..., Stage II [mild])

585.3 (..., Stage III [moderate])

  585.4 (..., Stage IV [severe])

585.5 (..., Stage V)

585.6 (End stage renal disease)

  585.9 (Chronic kidney disease, unspecified)

Take note: The title of the code has changed from "chronic renal failure" to "chronic kidney disease." Although agencies usually know if the patient has ESRD (those with ESRD are qualified to receive dialysis), they may not know what stage the kidney disease is otherwise.

In this case, you should contact the physician to verify the disease's stage. Use the unspecified code (585.9) only as a last resort.