Learn about Chronic Kidney Disease Stage 3a (CKD 3a), including diagnosis criteria, clinical documentation tips, and medical coding information for CKD stage 3. Understand GFR ranges, treatment options, and management strategies for moderate chronic kidney disease. This resource provides healthcare professionals with essential information on CKD3a for accurate clinical documentation and coding.
Also known as
Chronic kidney disease, stage 3A
Moderately decreased kidney function.
Disorders of kidney and ureter
Includes various kidney diseases, including chronic kidney disease.
Hypertensive diseases
High blood pressure, a common cause and complication of CKD.
Diabetes mellitus
A leading cause of chronic kidney disease.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the documented diagnosis Chronic Kidney Disease stage 3a?
Yes
Is there documentation of cause?
No
Do not code as N18.30 or N18.31. Review documentation for correct diagnosis.
When to use each related code
| Description |
|---|
| Moderate kidney damage with mildly decreased GFR (45-59 mL/min). |
| Mildly decreased kidney function with GFR 60-89 mL/min, often asymptomatic. |
| Severely decreased kidney function with GFR 30-44 mL/min, noticeable symptoms may be present. |
Lack of sufficient documentation to support CKD stage 3a, such as GFR and albuminuria levels, leading to potential downcoding or denial.
Coding to a less specific CKD stage (e.g., CKD unspecified) instead of the documented stage 3a, impacting reimbursement and quality metrics.
Insufficient documentation of coexisting conditions like hypertension or diabetes, which are crucial for accurate risk adjustment and coding.
Q: What are the key differentiating factors in chronic kidney disease stage 3a management compared to earlier stages?
A: Chronic kidney disease stage 3a, characterized by an estimated glomerular filtration rate (eGFR) between 45 and 59 mL/min/1.73m2, requires a more proactive approach compared to earlier stages. While monitoring blood pressure and proteinuria remain crucial, stage 3a necessitates closer attention to potential complications like anemia, mineral bone disorders, and cardiovascular disease. Consider implementing more frequent monitoring of hemoglobin, calcium, phosphorus, parathyroid hormone, and lipid profiles. Explore how early interventions, such as dietary phosphorus restriction and initiation of renin-angiotensin-aldosterone system (RAAS) inhibitors, can slow disease progression and mitigate cardiovascular risk. Furthermore, patient education on lifestyle modifications, including dietary sodium restriction and regular exercise, becomes increasingly important at this stage.
Q: How can I accurately assess and manage proteinuria in a patient diagnosed with CKD stage 3a to slow progression?
A: Accurate assessment of proteinuria in CKD stage 3a is crucial for prognostication and guiding treatment. A urine albumin-to-creatinine ratio (UACR) should be used to quantify proteinuria, and a 24-hour urine collection may be considered for precise measurement. Managing proteinuria in this stage primarily involves optimizing blood pressure control, preferably with RAAS inhibitors (ACE inhibitors or ARBs), as they have demonstrated renoprotective effects. Titrating these medications to the maximum tolerated dose while closely monitoring potassium levels and kidney function is essential. Explore how incorporating non-pharmacological interventions, such as dietary protein restriction and weight management, can further contribute to reducing proteinuria and slowing CKD progression. Learn more about emerging therapies and ongoing research in proteinuria management for CKD 3a.
Patient presents with chronic kidney disease stage 3a (CKD 3a), also known as moderate chronic kidney disease. Diagnosis is based on an estimated glomerular filtration rate (eGFR) between 45 and 59 mL/min/1.73 m2, consistent with National Kidney Foundation KDOQI guidelines. Patient's medical history includes [Insert relevant medical history, e.g., hypertension, diabetes, family history of kidney disease]. Physical examination reveals [Insert relevant physical exam findings, e.g., normal heart sounds, no edema]. Laboratory results indicate [Insert specific lab values for creatinine, BUN, GFR, and urine albumin creatinine ratio (UACR)]. Current medications include [List current medications]. Assessment includes moderate chronic kidney disease stage 3a with [mention complications if any, e.g., controlled hypertension, no proteinuria]. Plan includes monitoring of renal function with regular eGFR and UACR measurements, management of comorbidities such as [mention specific comorbidity management e.g., blood pressure control with prescribed antihypertensives, glycemic control with prescribed antidiabetic medication], patient education on renal diet, and referral to a nephrologist for co-management and further evaluation. ICD-10 code N18.3 is documented for this encounter. Follow-up scheduled in [ timeframe e.g. 3 months] to reassess renal function and adjust treatment plan as needed.