Understanding End-Stage Kidney Disease (ESRD) diagnosis, documentation, and medical coding is crucial for healthcare professionals. This resource provides information on ESRD, also known as End-Stage Renal Disease, including clinical documentation requirements, ICD-10 codes, and best practices for accurate medical coding for ESKD. Learn about staging, treatment options, and relevant healthcare guidelines for End-Stage Renal Disease patients.
Also known as
Chronic kidney disease, stage 5
End-stage renal disease requiring dialysis or transplant.
End-stage renal disease
Unspecified end-stage renal disease.
Dependence on renal dialysis
Patient requires dialysis for chronic kidney failure.
Complications of kidney transplant
Problems arising after a kidney transplant procedure.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the patient receiving chronic dialysis?
Yes
Is it hemodialysis?
No
Has the patient received a kidney transplant?
When to use each related code
| Description |
|---|
| Total kidney failure requiring dialysis or transplant. |
| Decreased kidney function, not yet end-stage. |
| Acute kidney injury, rapid decline in function. |
Coding ESRD requires specifying the underlying cause and stage, impacting reimbursement and quality reporting. Miscoding leads to inaccurate severity reflection.
Chronic Kidney Disease (CKD) and ESRD are distinct. Incorrectly coding CKD as ESRD or vice versa leads to inaccurate clinical documentation and claims.
ESRD often involves dialysis. Insufficient documentation of dialysis type and frequency can lead to undercoding and lost revenue.
Q: What are the most effective strategies for managing fluid overload in patients with end-stage renal disease (ESRD) requiring dialysis?
A: Fluid overload is a common complication in ESRD patients on dialysis, contributing to hypertension, heart failure, and pulmonary edema. Effective management strategies include optimizing ultrafiltration during dialysis sessions, closely monitoring interdialytic weight gain, and implementing dietary sodium and fluid restrictions. Consider implementing a multidisciplinary approach involving nephrologists, dietitians, and nurses to educate patients on fluid management and adherence to prescribed therapies. Explore how incorporating telehealth interventions can enhance patient monitoring and improve fluid balance outcomes in ESRD. Furthermore, careful assessment and management of comorbidities such as congestive heart failure are crucial to optimizing fluid status in these patients. Learn more about the latest guidelines for managing fluid overload in ESRD.
Q: How can clinicians differentiate between acute kidney injury (AKI) and end-stage renal disease (ESRD) when evaluating a patient with severely decreased kidney function?
A: Differentiating between AKI and ESRD requires a thorough evaluation encompassing clinical presentation, laboratory findings, and imaging studies. AKI is characterized by a rapid decline in kidney function, often reversible with appropriate management, whereas ESRD represents irreversible kidney damage requiring renal replacement therapy. Key distinctions include evaluating for the presence of underlying causes potentially contributing to AKI, such as nephrotoxic medications or infections. Examining medical history for chronic kidney disease progression can suggest ESRD. Explore how serial measurements of serum creatinine and glomerular filtration rate can be used to monitor disease trajectory and guide treatment decisions. While imaging may reveal structural abnormalities in both conditions, the chronicity of findings, such as small kidney size on ultrasound, often points towards ESRD. Learn more about the specific diagnostic criteria for AKI and ESRD to aid in accurate diagnosis and appropriate management.
Patient presents with end-stage renal disease (ESRD), also known as end-stage kidney disease, confirmed by estimated glomerular filtration rate (eGFR) consistently below 15 mL/min/1.73 m2 and the presence of uremic symptoms. The patient meets the clinical criteria for chronic kidney disease stage 5, requiring renal replacement therapy (RRT). Clinical manifestations include fatigue, nausea, vomiting, loss of appetite, swelling in the legs and feet, and sleep disturbances. Laboratory findings reveal elevated creatinine and blood urea nitrogen (BUN) levels, hyperphosphatemia, and metabolic acidosis. Diagnostic workup included renal ultrasound demonstrating small, echogenic kidneys consistent with chronic disease. Patient's medical history is significant for hypertension and type 2 diabetes mellitus, both contributing factors to the development of ESRD. Treatment plan includes initiation of hemodialysis, management of fluid and electrolyte imbalances, dietary phosphorus restriction, and medication management for blood pressure control and anemia related to chronic kidney disease. Referral to a nephrologist and a registered dietitian specializing in renal nutrition has been made. Prognosis and potential complications of ESRD, including cardiovascular disease and mineral bone disorder, were discussed with the patient. Patient education provided regarding dialysis options, medication adherence, and dietary restrictions. Follow-up appointments scheduled for monitoring of dialysis adequacy, electrolyte levels, and overall clinical status. ICD-10 code N18.6 assigned.