The new codes are for describing the infusion of tixagevimab and cilgavimab monoclonal antibody (code XW023X7), and the infusion of other new technology monoclonal antibody (code XW023Y7).
Why ICD-10 codes are important
ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.
Acute kidney failure, unspecified N17. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM N17. 9 became effective on October 1, 2021.
Acute kidney injury (AKI), also known as acute renal failure (ARF), is a sudden episode of kidney failure or kidney damage that happens within a few hours or a few days. AKI causes a build-up of waste products in your blood and makes it hard for your kidneys to keep the right balance of fluid in your body.
ICD-10-CM code N28. 9 is reported to capture the acute renal insufficiency. Based on your documentation, acute kidney injury/failure (N17. 9) cannot be assigned.
The management of AKI involves identifying and treating the underlying case as well as minimizing complications. AKI is usually reversible. In contrast, CKD develops gradually, over months to years, as a result of chronic illnesses such as diabetes and hypertension.
Causes of AKI can be classified into three broad groups: (1) pre-renal or hemodynamic (i.e., hypoperfusion to the kidney), (2) intrinsic (i.e., structural damage to the kidney), and (3) post-renal (i.e., obstruction of urinary outflow).
Acute renal failure (ARF) can be divided into three main types: perennial, renal, and postrenal.
N18. 31- Chronic Kidney Disease- stage 3a. N18. 32- Chronic Kidney Disease- stage 3b.
N19 - Unspecified kidney failure. ICD-10-CM.
ICD-10 code N18. 3 for Chronic kidney disease, stage 3 (moderate) is a medical classification as listed by WHO under the range - Diseases of the genitourinary system .
Kidney disease means your kidneys aren't working properly. Chronic kidney disease (CKD) means your kidney function slowly gets worse with time. High blood pressure and diabetes are two common causes of CKD.
Underlying CKD is now recognized as a clear risk factor for AKI, as both decreased glomerular filtration rate (GFR) and increased proteinuria have each been shown to be strongly associated with AKI. A growing body of literature also provides evidence that AKI accelerates the progression of CKD.
Kidney failure is when your kidneys have stopped working well enough for you to survive without dialysis or a kidney transplant. Your kidneys have lost their ability to filter waste from your blood. Kidney failure is also called end-stage kidney disease (ESKD) or end-stage renal disease (ESRD).
Acute renal/kidney failure or injury is a sudden, severe onset of inadequate kidney function. There are many causes of acute renal/kidney failure/injury, however, when due to dehydration, it is because there is decreased renal blood flow from lower blood pressure because of the dehydration. This starts causing functioning problems with the kidney.
Symptoms include oliguria, edema resulting from salt and water overload, nausea and vomiting, lethargy from the toxic effects of the waste products building up, hydronephrosis and at times metabolic acidosis. BUN and creatinine will be significantly elevated.
KDIGO (Kidney Disease: Improving Global Outcomes group ) Treatment involves treating the underlying cause, and if due to dehydration, that means treating the dehydration with fluids. Renal function (BUN, creatinine) would be followed and monitored along with fluid intake.
The coder should not be shy about escalating a case to CDI or a physician adviser if either diagnosis does not seem to be clinically validated, as this is part of a coder’s responsibility. As can be seen in the DRGs above, choosing one of these diagnoses over the other as PDX can impact reimbursement.
BUN and creatinine will be significantly elevated. There are several types of criteria for acute kidney failure/injury and some hospitals compile their own. Some well known clinical criteria for validating this diagnosis are: RIFLE (Risk of renal dysfunction, Injury to kidney, Failure or Loss of kidney function,
ATN occurs when there is damage to the kidney tubule cells. These are the cells that reabsorb fluid and minerals in the kidney from urine as it is forming. When this occurs, there is a lack of oxygen reaching the cells of your kidneys. N17.1—Acute kidney failure with acute cortical necrosis.
Other terms that may be used to describe ATN could be renal tubular necrosis or tubular necrosis. These are terms that should be searched for when AKI is documented to see if there could be further specificity in code assignment. ATN occurs when there is damage to the kidney tubule cells.