ICD-9 and ICD-10 both assume a cause-and-effect relationship between chronic kidney disease and hypertension.  When the patient has both conditions, ICD presumes a relationship and codes “Hypertensive Chronic Kidney Disease” (unless the doctor states otherwise).MCBblog_-_renal_failure

The coding rules are very similar between the two code sets, but the codes vary.  In ICD-9-CM a code from category 403, Hypertensive Kidney Disease, should be listed first, followed by an additional code to identify the stage of the chronic kidney disease, a code from category 585. Don’t forget to use fourth and fifth digits with the 403 code. Fourth digits available for the 585 code are listed below.

In ICD-10-CM Hypertensive Chronic Kidney Disease code category is I12. Don’t forget to use a fourth digit (either I12.0 or I12.9). This needs to be followed by an additional code from category N18 to specify the stage of the chronic kidney disease.

Here is a breakdown of the stage codes between ICD-10 and ICD-9:

Chronic Kidney DiseaseICD-10-CMICD-9-CM
Stage 1N18.1585.1
Stage 2N18.2585.2
Stage 3N18.3585.3
Stage 4N18.4585.4
Stage 5N18.5585.5
End Stage Renal diseaseN18.6585.6

The healthcare provider needs to document the stage of the chronic kidney disease.

Nancy Reading, RN, BS, CPC, CPC-P, CPC-I, wrote an article on renal failure in the latest September 2015 publication of the Healthcare Business Monthly from AAPC, pages 20-23.  It contains excellent information on the physiology of kidney disease; check it out!

For more information on coding hypertensive chronic kidney disease please see guideline I.C.7.a.3 in ICD-9-CM and guidelines I.C.9.a.3 in ICD-10-CM.

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