The Centers for Medicare & Medicaid Services (CMS) Office of Minority Health (OMH) has announced that March is National Kidney Month.
Chronic kidney disease (CKD) affects 14 percent of adults in the United States. Risk factors for CKD include hypertension, diabetes, obesity, and heart disease. The OMH states that Black Americans are more affected by the disease, at 20 percent. Asian Americans and Hispanic Americans are affected by CKD at the same rate – 14 percent.
The coding of CKD can be found in Chapter 14 (Diseases of the Genitourinary System); the codes begin with “N”. This condition is affected by the Official Coding and Reporting Guidelines of I.A.15 (With). This guideline states, “the word ‘with’ or ‘in’ should be interpreted to mean ‘associated with’ or ‘due to’ when it appears in a code title, the Alphabetic Index (either under a main term or subterm), or an instructional note in the Tabular List. The classification presumes a causal relationship between the two conditions linked by these terms in the Alphabetic Index or Tabular List.”
The ICD-10-CM FY2024 Index for CKD shows the following coding options:
When coding chronic kidney disease, first, the stage needs to be specific in code assignment. The next step is to identify any related conditions, such as hypertension, pregnancy, or schistosomiasis.
If the patient has hypertension of chronic kidney disease, the coder is instructed to look at the entry of Hypertension, kidney. The Index displays this information:
If the patient has Stage 3 CKD and hypertension, then the coder would assign I12.9. The coder should open the ICD-10-CM Tabular volume to I12, which shows the following information:
The Tabular volume under code I12.9 directs the coder to also assign a code from the N18.1-N18.4 or N18.9, based on the CKD stage. In this case, the coder would assign N18.30, as there is no further specificity. This lack of documentation would be an opportunity for provider education, as well as a query to request the documentation. The Tabular volume shows this information for N18.3:
If the provider documents in the patient’s chart that the patient has CKD Stage 3a, or “hypertension, CKD IIIa,” then the coder should assign I12.9 and N18.31 for hypertensive CKD. The guidelines state that the relationship between hypertension and chronic kidney disease may be assumed.
The use of the preposition “with” is one difficult concept to understand for new coders. That concept is used when coding hypertension with CKD. Make sure that you are coding CKD correctly as we recognize National Kidney Month.
The Centers for Medicare & Medicaid Services (CMS) released in its 2025 Outpatient Prospective Payment System (OPPS) Final Rule a new Conditions of Participation (CoPs)
Coding in the post-acute care world has taken on a new significance in the past five years. For those of us who are coders, this
Please log in to your account to comment on this article.
Join Beth Wolf, MD, CPC, CCDS, for an in-depth webcast on the FY2025 spinal fusion MS-DRG updates. Discover key changes in DRG classification, understand impacts on documentation and CMI, and learn strategies to ensure compliance.
Join Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, as she presents effective strategies to strengthen collaboration between CDI, coding, and quality departments in acute care hospitals. Angela will also share guidance on implementing cross-departmental meetings, using shared KPIs, and engaging leadership to foster a culture of collaboration. Attendees will gain actionable tools to optimize documentation accuracy, elevate quality metrics, and drive a unified approach to healthcare goals, ultimately enhancing both patient outcomes and organizational performance.
Optimize your outpatient clinical documentation and gain comprehensive knowledge from foundational practices to advanced technologies, ensuring improved patient care and organizational and financial success. This webcast bundle provides a holistic approach to outpatient CDI, empowering you to implement best practices from the ground up and leverage advanced strategies for superior results. You will gain actionable insights to improve documentation quality, patient care, compliance, and financial outcomes.
Enhancing outpatient clinical documentation is crucial for maintaining accuracy, compliance, and proper reimbursement in today’s complex healthcare environment. This webcast, presented by industry expert Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, will provide you with actionable strategies to tackle complex challenges in outpatient documentation. You’ll learn how to craft detailed clinical narratives, utilize advanced EHR features, and implement accurate risk adjustment and HCC coding. The session also covers essential regulatory updates to keep your documentation practices compliant. Join us to gain the tools you need to improve documentation quality, support better patient care, and ensure financial integrity.
Dr. Ronald Hirsch provides critical details on the new Medicare Appeal Process for Status Changes for patients whose status changes during their hospital stay. He also delves into other scenarios of hospital patients receiving custodial care or medically unnecessary services where patient notifications may be needed along with the processes necessary to ensure compliance with state and federal guidance.
Healthcare organizations face complex regulatory requirements under the No Surprises Act and Price Transparency rules. These policies mandate extensive fee disclosures across settings, and confusion is widespread—many hospitals remain unaware they must post every contracted rate. Non-compliance could lead to costly penalties, financial loss, and legal risks. Join David M. Glaser Esq. as he shows you how to navigate these regulations effectively.
Protect your facility from unwanted audits! Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, and take a deep dive into both the CMS and AMA guidelines for reporting post operative pain blocks. You’ll learn how to determine if the nerve block is separately codable with real life examples for better understanding. Becky will also cover how to evaluate whether documentation supports medical necessity, offer recommendations for stronger documentation practices, and provide guidance on educating providers about documentation requirements. She’ll include a discussion of appropriate modifier and diagnosis coding assignment so that you can be confident that your billing of post operative pain blocks is fully supported and compliant.
During this RACmonitor webcast Dr. Ronald Hirsch spotlights the areas of the OIG’s Work Plan and the findings of their most recent audits that impact utilization review, case management, and audit staff. He also provides his common-sense interpretation of the prevailing regulations related to those target issues. You’ll walk away better equipped with strategies to put in place immediately to reduce your risk of paybacks, increased scrutiny, and criminal penalties.
Copyright © 2024 ICD10monitor. Powered by MedLearn Media.
Prepare for the 2025 CMS IPPS Final Rule with ICD10monitor’s IPPSPalooza! Click HERE to learn more
Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!
