Understanding Stage 3 CKD diagnosis, clinical documentation, and medical coding? Find information on GFR, creatinine levels, proteinuria, hypertension management, and ICD-10 codes N18.30 and N18.31 for Stage 3 Chronic Kidney Disease. Learn about treatment options, renal diet, and healthcare resources for managing Stage 3 CKD.
Also known as
Chronic kidney disease, stage 3
Mild to moderate reduction in kidney function.
Hypertensive chronic kidney disease
Kidney disease caused by high blood pressure.
Hypertensive heart and CKD without HF
High blood pressure affecting heart and kidneys.
Type 2 diabetes with nephropathy
Kidney damage due to type 2 diabetes.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the CKD diagnosis confirmed?
Yes
Is GFR documented?
No
Do NOT code N72.2. Query physician.
When to use each related code
| Description |
|---|
| Stage 3 Chronic Kidney Disease |
| Stage 2 Chronic Kidney Disease |
| Diabetic Nephropathy |
Coding CKD Stage 3 without specifying A or B (based on GFR and albuminuria) leads to inaccurate risk adjustment and reimbursement.
Conditions like hypertension and diabetes, common with CKD, may be coded incorrectly as complications instead of comorbidities, impacting quality metrics.
Lack of proper documentation confirming Stage 3 CKD diagnosis (e.g., GFR, albuminuria results) exposes claims to denials during audits for lacking medical necessity.
Q: What are the most effective strategies for managing Stage 3 Chronic Kidney Disease in patients with comorbid hypertension and diabetes?
A: Managing Stage 3 Chronic Kidney Disease (CKD) in patients with hypertension and diabetes requires a multifaceted approach. Strict blood pressure control is paramount, often achieved with angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs), as these medications have demonstrated renoprotective effects beyond blood pressure lowering. Similarly, meticulous glycemic control through lifestyle modifications and appropriate antidiabetic medications is crucial to slow CKD progression. Furthermore, dietary protein restriction, typically 0.6-0.8 grams per kilogram of body weight per day, can help reduce the burden on the kidneys. Beyond these core interventions, optimizing lipid profiles, addressing anemia with iron supplementation or erythropoiesis-stimulating agents (ESAs) as needed, and managing mineral bone disorders are also essential. Explore how a multidisciplinary approach involving nephrologists, endocrinologists, and dietitians can improve patient outcomes in complex Stage 3 CKD cases.
Q: How do I differentiate between Stage 3a and Stage 3b Chronic Kidney Disease, and what are the key implications for treatment decisions?
A: Differentiating between Stage 3a and Stage 3b Chronic Kidney Disease (CKD) primarily relies on estimated glomerular filtration rate (eGFR). Stage 3a CKD is defined by an eGFR of 45-59 mL/min/1.73m2, while Stage 3b CKD indicates an eGFR of 30-44 mL/min/1.73m2. While both stages share common management principles such as blood pressure control, glycemic management if diabetic, and addressing cardiovascular risk factors, the intensity of interventions may differ. Patients in Stage 3b, having a lower eGFR, are at higher risk of progression to end-stage renal disease (ESRD) and may require closer monitoring and earlier referral to a nephrologist. Consider implementing more frequent eGFR assessments and proactive management of complications like anemia and mineral bone disorders in Stage 3b CKD patients. Learn more about the specific diagnostic criteria and treatment guidelines for each sub-stage to ensure optimal patient care.
Patient presents with Stage 3 Chronic Kidney Disease (CKD), confirmed by estimated glomerular filtration rate (eGFR) between 30 and 59 mLmin1.73 m2, persistent for at least three months. Presenting complaints include fatigue, changes in urination (frequency, nocturia, foamy urine), swelling in the ankles, feet, or hands, and occasional shortness of breath. Relevant laboratory findings demonstrate elevated creatinine and blood urea nitrogen (BUN) levels. Urinalysis may reveal proteinuria or hematuria. Patient history includes hypertension, managed with lisinopril, and a family history of diabetes, though the patient's HbA1c is currently within normal limits. Assessment includes evaluation for secondary causes of CKD, such as diabetic nephropathy, hypertensive nephrosclerosis, and glomerulonephritis. Differential diagnosis considered other conditions impacting kidney function, including acute kidney injury (AKI) and urinary tract infections. Treatment plan focuses on slowing CKD progression through blood pressure control optimization with continued lisinopril and initiation of lifestyle modifications including dietary sodium restriction, regular exercise, and smoking cessation counseling. Referral to nephrology for co-management and further evaluation is warranted. Patient education provided regarding CKD management, including medication adherence, dietary recommendations, and the importance of regular monitoring of kidney function. Follow-up scheduled in three months to reassess kidney function, monitor blood pressure, and evaluate treatment efficacy. ICD-10 code N18.3 assigned.