Find comprehensive information on History of Nephrectomy diagnosis, including clinical documentation tips, ICD-10 codes (Z90.81), medical coding guidelines, and healthcare resources. Learn about post-nephrectomy care, complications, and long-term health management for patients with a history of kidney removal surgery. This resource offers valuable insights for physicians, coders, and other healthcare professionals seeking accurate and up-to-date information on History of Nephrectomy.
Also known as
Persons with potential health hazards
Covers acquired absence of organs, including kidney.
Chronic kidney disease
May be relevant if nephrectomy led to CKD.
Hypertensive diseases
Relevant if nephrectomy related to hypertension.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the nephrectomy total or partial?
Total
Which kidney was removed?
Partial
Which kidney was partially removed?
When to use each related code
| Description |
|---|
| History of Nephrectomy |
| Chronic Kidney Disease |
| Renal Hypertension |
Missing or unclear documentation of right, left, or bilateral nephrectomy leading to inaccurate coding (e.g., Z90.5 vs. N18.81, N18.82).
Unspecified or poorly documented reason for nephrectomy affecting code selection for primary malignancy (e.g., C64 vs. status code Z90.5).
Coding Z90.5 in inappropriate encounters (e.g., active treatment) when other codes may be more relevant for present illness.
Q: What are the key historical milestones in the development of nephrectomy surgical techniques, from open to minimally invasive approaches?
A: The history of nephrectomy spans several significant milestones. Early nephrectomies were performed via large open incisions, carrying significant morbidity. The first successful nephrectomy was performed in 1869 by Gustav Simon. The 20th century saw refinements in open techniques, including improvements in anesthesia and surgical instrumentation. The advent of minimally invasive surgery revolutionized nephrectomy. Laparoscopic nephrectomy emerged in the 1990s, offering reduced postoperative pain, shorter hospital stays, and faster recovery. Subsequently, robotic-assisted laparoscopic nephrectomy further enhanced precision and dexterity for complex cases. Consider implementing a minimally invasive approach whenever feasible, taking into account patient-specific factors and tumor characteristics. Explore how different surgical approaches have impacted patient outcomes over time.
Q: How has the understanding of nephrectomy indications evolved over time, considering advancements in diagnostic imaging and active surveillance protocols for renal masses?
A: Historically, nephrectomy was often indicated for any renal mass suspected of malignancy. However, advancements in diagnostic imaging, particularly CT and MRI, allow for better characterization of renal masses, differentiating benign lesions from malignant tumors. This refined diagnostic capability has led to a more nuanced approach to treatment. Active surveillance protocols have emerged as a viable option for small renal masses with low malignant potential, reducing the number of unnecessary nephrectomies. Furthermore, the understanding of renal function preservation has also evolved. Partial nephrectomy, where only the affected portion of the kidney is removed, is now favored whenever possible to preserve renal function, especially in patients with pre-existing renal insufficiency or solitary kidney. Learn more about current guidelines for renal mass evaluation and management to ensure optimal patient care.
This patient presents with a history of nephrectomy. The patient reports a remote history of right left or bilateral kidney removal. Documentation supporting the nephrectomy including operative reports pathology reports and discharge summaries should be obtained and reviewed. The indication for the prior nephrectomy was documented as renal cell carcinoma, kidney stones, chronic kidney disease, traumatic injury, or other specified condition. The date of the nephrectomy was documented as Month Year. Current complaints possibly related to the history of nephrectomy such as flank pain, hematuria, proteinuria, hypertension, or decreased renal function are evaluated. Physical examination findings relevant to the nephrectomy history such as the presence or absence of a surgical scar, costovertebral angle tenderness, or abdominal masses are noted. Laboratory data including serum creatinine, glomerular filtration rate (GFR), urinalysis, and complete blood count are reviewed to assess current renal function and overall health status. Imaging studies such as renal ultrasound, CT scan, or MRI may be considered to evaluate the remaining kidney or assess for any complications. The patient is counseled on the importance of regular monitoring of renal function given their history of nephrectomy. Management will focus on optimizing remaining kidney function and addressing any complications related to the prior nephrectomy. Follow-up care with nephrology or urology as indicated. ICD-10 code Z90.81 (acquired absence of kidney) is appropriate for this patient with a history of nephrectomy. Medical billing and coding for subsequent evaluations and treatment will be dependent on the specific presenting complaints and clinical findings.