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N19
ICD-10-CM
Renal Insufficiency

Understanding Renal Insufficiency: Find information on diagnosis codes (ICD-10-CM N17.9, N17), clinical documentation improvement for renal failure, chronic kidney disease (CKD) stages, acute kidney injury (AKI), GFR (glomerular filtration rate), creatinine levels, and treatment options. Learn about medical coding guidelines for renal insufficiency, kidney disease documentation requirements, and healthcare resources for patients with impaired kidney function.

Also known as

Kidney Insufficiency
Renal Failure

Related ICD-10 Code Ranges

Complete code families applicable to AAPC N19 Coding
N75.0-N75.9

Unspecified renal failure

Covers various stages of kidney failure without further specification.

N17-N19

Acute kidney failure

Sudden loss of kidney function requiring prompt treatment.

I12.0-I13.1

Hypertensive kidney disease

Kidney damage from high blood pressure, a cause of renal insufficiency.

N00-N88

Diseases of the urinary system

Broad category including many causes and forms of renal insufficiency.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the renal insufficiency acute?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Kidney function decreased, not yet ESRD.
Acute Kidney Injury (AKI)
Chronic Kidney Disease (CKD)

Documentation Best Practices

Documentation Checklist
  • Renal insufficiency diagnosis documented
  • Severity of renal insufficiency specified (acute, chronic, stage)
  • GFR and creatinine levels documented
  • Underlying cause of renal insufficiency noted if known
  • Treatment plan and follow-up documented

Coding and Audit Risks

Common Risks
  • Unspecified Stage

    Coding renal insufficiency without specifying the stage (e.g., acute, chronic, stage 1-5) leads to inaccurate severity reflection and reimbursement.

  • Comorbidity Coding

    Missing documentation and coding of related conditions like hypertension and diabetes impacts risk adjustment and quality reporting.

  • Acute vs. Chronic

    Misclassifying acute kidney injury (AKI) as chronic kidney disease (CKD) or vice versa affects treatment and prognosis coding accuracy.

Mitigation Tips

Best Practices
  • Document detailed GFR, creatinine levels for accurate CKD staging (ICD-10-CM N18.x)
  • Specific coding for cause of Renal Insufficiency improves risk adjustment (HCCs)
  • Query physician for clarification on acute vs. chronic renal failure diagnosis
  • Ensure documentation supports medical necessity for renal services (E/M coding)
  • Regularly audit renal documentation for CDI & compliance with coding guidelines

Clinical Decision Support

Checklist
  • 1. Verify reduced eGFR (<60 mL/min/1.73 m2) documented
  • 2. Confirm duration >3 months per ICD-10 guidelines
  • 3. Review creatinine, BUN for elevated levels
  • 4. Check for causative factors: AKI, CKD documentation
  • 5. Assess patient symptoms: fatigue, edema, etc.

Reimbursement and Quality Metrics

Impact Summary
  • Renal Insufficiency reimbursement hinges on accurate coding (N18.9, N18.4, etc.) and documented severity for optimal MDC assignment.
  • Coding errors impact Renal Insufficiency DRG assignment, affecting hospital case mix index and potential revenue.
  • Quality metrics for Renal Insufficiency include monitoring GFR, blood pressure control, and patient education adherence impacting value-based payments.
  • Timely diagnosis coding and staging improve Renal Insufficiency patient risk stratification and resource allocation reporting.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code CKD stage, not just RI
  • Document GFR and creatinine
  • Specify acute or chronic
  • Look for underlying cause codes
  • Consider dialysis/transplant codes

Documentation Templates

Patient presents with signs and symptoms suggestive of renal insufficiency, also known as chronic kidney disease CKD.  Presenting complaints include fatigue, decreased urine output oliguria, swelling in the extremities edema, and shortness of breath dyspnea.  The patient reports a history of hypertension, a significant risk factor for kidney disease, and recent lab work reveals elevated creatinine and blood urea nitrogen BUN levels, indicative of impaired kidney function.  Glomerular filtration rate GFR, calculated using the CKD-EPI equation, is currently estimated at [Insert GFR value] mLmin1.73 m2, placing the patient in CKD stage [Insert Stage].  Urinalysis shows proteinuria, further supporting the diagnosis.  Differential diagnosis includes acute kidney injury AKI, but the chronic nature of the patient's hypertension and progressive decline in renal function point towards chronic kidney disease.  Treatment plan includes aggressive blood pressure management with [Specify medication class e.g., ACE inhibitors, ARBs], dietary modifications focusing on protein restriction and sodium reduction, and close monitoring of renal function with regular laboratory assessments of creatinine, BUN, and GFR. Patient education regarding renal diet, fluid management, and medication adherence will be provided.  Referral to a nephrologist is recommended for ongoing management of chronic kidney disease.  ICD-10 code N18. [Specify stage if documented] will be used for billing and coding purposes.
Renal Insufficiency - AI-Powered ICD-10 Documentation