Wiki DM and unspecified CKD in ICD 10 coding

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rvalente

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Hi All,
wondering if you could please weigh in with your thoughts on coding the following scenario.

Pt has DM with unspecified CKD. Per the instruction note under code E11.22 - it states to use an additional code to identify stage of CKD (N18.1-N18.6).

Since the code range doesn't include the code N18.9 for the unspecified CKD, I'm wondering if it should still be captured.

Thank you
 
Yes still capture the CKD code. In my book it has coding tips and states to "Assign additional code from N18- to indicate the stage of CKD." That would include the CKD, unspecified. I work in home health so we don't get the opportunity to query the physician, but if you do, I would try to get them to specific the stage.
 
ancoleman22 said:
Yes still capture the CKD code. In my book it has coding tips and states to "Assign additional code from N18- to indicate the stage of CKD." That would include the CKD, unspecified. I work in home health so we don't get the opportunity to query the physician, but if you do, I would try to get them to specific the stage.
Click to expand...

Thank you, I also work remotely without the benefit of being able to query the physician. There is much debate amongst my peers regarding this scenario so I appreciate your weighing in!
 
rvalente said:
Thank you, I also work remotely without the benefit of being able to query the physician. There is much debate amongst my peers regarding this scenario so I appreciate your weighing in!
Click to expand...

Also, I was just looking at my book for a case and there is a + which means an additional code required so therefore I would still code the CKD, unspecified or it would appear as if you were missing a code.

I would love to work remotely someday but with all these ICD 10 changes, I'd have to many questions! haha

Hope this helps!
 
You are correct about the coding as E11.22, N18.9.

E11.22 includes both the DM and the CKD, so all you would need to add is the stage of the CKD. Although you're reporting a DX code for CKD, you're not reporting the disease itself as it's included in E11.22; you are just using the additional code to indicate the stage. In other words, E11.22 is the DX for both the DM and the CKD. The N18.9 is basically an "informational" code to indicate the stage of the CKD.

There would be no additional codes to use unless you need to include insulin use, which would be Z79.4.
 
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