Understanding low urine output oliguria anuria diagnosis and treatment is crucial for healthcare professionals. This resource provides information on clinical documentation best practices medical coding ICD-10 codes N13.9 R34 and SNOMED CT concepts for oliguria anuria and low urine volume. Learn about causes symptoms and management of decreased urine production in adults and children including acute kidney injury AKI dehydration and urinary tract obstruction. Explore guidelines for accurate diagnosis and appropriate medical coding for low urine output to ensure optimal patient care and accurate reimbursement.
Also known as
Anuria and oliguria
Covers conditions of absent or diminished urine production.
Other disorders of kidney and ureter
Includes unspecified kidney disorders that may cause low urine output.
General symptoms and signs
May include dehydration and other symptoms related to reduced urine.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is oliguria due to acute kidney injury (AKI)?
Yes
Stage of AKI documented?
No
Is oliguria due to dehydration?
When to use each related code
| Description |
|---|
| Low Urine Output |
| Acute Kidney Injury |
| Dehydration |
Coding oliguria without specifying cause (prerenal, renal, postrenal) can lead to claim denials and inaccurate severity reflection.
Failing to code underlying conditions like dehydration, AKI, or obstruction contributing to low urine output impacts DRG assignment.
Vague documentation lacking specific urine output measurements and duration hinders accurate coding and audit defense.
Q: What are the most common differential diagnoses to consider in a patient presenting with oliguria and how can I differentiate between them?
A: Oliguria, defined as urine output less than 0.5 mL/kg/hour in adults or less than 1 mL/kg/hour in children, requires prompt evaluation to identify the underlying cause. Common differential diagnoses include prerenal causes (e.g., dehydration, hypovolemia, heart failure, sepsis), renal causes (e.g., acute tubular necrosis, acute interstitial nephritis, glomerulonephritis), and postrenal causes (e.g., urinary tract obstruction, bladder dysfunction). Differentiating between these requires a thorough clinical assessment, including evaluating volume status (e.g., orthostatic vital signs, jugular venous pressure), reviewing medications, assessing for signs of infection, and analyzing laboratory data such as serum creatinine, BUN, and urine electrolytes. Explore how fractional excretion of sodium (FENa) and urine osmolality can help distinguish prerenal from renal causes. Further imaging studies like renal ultrasound or CT scan may be necessary to identify postrenal obstruction or assess renal parenchyma. Consider implementing a diagnostic algorithm for oliguria in your practice to ensure a systematic approach. Learn more about the specific management strategies for each category of oliguria.
Q: How can I rapidly assess and manage a critically ill patient with acute oliguria in the ICU setting, considering potential complications?
A: Rapid assessment and management of acute oliguria in the ICU are crucial to prevent potential complications like acute kidney injury (AKI). Begin by ensuring hemodynamic stability, including adequate intravascular volume and appropriate blood pressure support. Evaluate for signs of sepsis and initiate appropriate antibiotic therapy if suspected. Closely monitor fluid balance, electrolyte levels, and acid-base status. Consider the impact of nephrotoxic medications and adjust or discontinue them as needed. Early initiation of renal replacement therapy (RRT) may be indicated in severe cases of oliguria with volume overload, electrolyte abnormalities, or uremia refractory to medical management. Explore the latest guidelines for AKI management in critically ill patients. Learn more about the indications and timing of RRT initiation in the ICU setting.
Patient presents with oliguria, defined as low urine output, less than 400 mL per 24 hours or less than 0.5 mL/kg/hour in adults. Assessment reveals decreased urine production concerning for acute kidney injury (AKI), potentially prerenal, renal, or postrenal in etiology. Patient reports [Insert subjective symptoms e.g., decreased fluid intake, flank pain, dysuria, abdominal discomfort, nausea, vomiting, edema]. Physical examination reveals [Insert objective findings e.g., vital signs including blood pressure and heart rate, signs of dehydration such as dry mucous membranes, skin turgor, and capillary refill time; abdominal tenderness; presence of edema]. Differential diagnosis includes dehydration, urinary tract obstruction, acute tubular necrosis (ATN), nephrotoxic medications, prerenal azotemia, and other causes of renal dysfunction. Laboratory investigations ordered include serum creatinine, blood urea nitrogen (BUN), electrolytes, urinalysis, and complete blood count (CBC) to assess renal function and identify potential underlying causes. Initial management includes fluid resuscitation with intravenous fluids to address potential dehydration and optimize renal perfusion. Further diagnostic testing, such as renal ultrasound or CT scan, may be indicated depending on the clinical course and response to initial interventions. Patient education provided on the importance of monitoring fluid intake and output and recognizing signs of worsening renal function. Plan to monitor urine output closely, reassess renal function with repeat laboratory tests, and adjust management accordingly. ICD-10 code R34.0 (Anuria and oliguria) is considered. Continued monitoring and evaluation are essential to determine the underlying cause of the oliguria and guide appropriate treatment strategies.