Q&A: Reporting acute renal insufficiency due to dehydration in ICD-10-CM. 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. However, based on the clinical indicators documented, a query should be submitted to the provider to specify if...
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.
When a patient develops acute renal failure during a hospital stay, sequence a code from category 584 as a secondary diagnosis.
There is not one “across the board” answer as to what diagnosis is PDX for every patient who is admitted with acute renal/kidney failure/injury and dehydration. The information contained in this post is valid at the time of posting.
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.
Dehydration, a condition that characterizes excessive loss of body water, is well known to be associated with acute renal dysfunction; however, it has largely been considered reversible and to be associated with no long-term effects on the kidney.
ICD-10 code E86. 0 for Dehydration is a medical classification as listed by WHO under the range - Endocrine, nutritional and metabolic diseases .
Acute renal failure (ARF) can be divided into three main types: perennial, renal, and postrenal.
A: The ICD-10-CM codes that would be most appropriate for this case are:N28. 9, disorder of kidney and ureter, unspecified.E86. 0, dehydration.
Acute Kidney Failure/Injury 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.
ICD-10 | Fever, unspecified (R50. 9)
The objective of this article is to examine the coding of hydration with CPT® codes 96360, Intravenous infusion, hydration; initial, 31 minutes to 1 hour, and 96361, Intravenous infusion, hydration; each additional hour. The purpose of hydration intravenous (IV) infusion is to hydrate.
ICD-10 code N18. 6 for End stage renal disease is a medical classification as listed by WHO under the range - Diseases of the genitourinary system .
On one hand, they may present manifestations of the underlying disease (e.g. heart failure, sepsis, systemic vasculitis, thrombotic microangiopathy). If renal function is truly affected the typical course of AKI includes 4 stages: (I) initiation, (II) oligo-anuria, (III) polyuria, and (IV) restitution.
Prerenal acute renal failure is characterized by diminished renal blood flow (60 to 70 percent of cases). In intrinsic acute renal failure, there is damage to the renal parenchyma (25 to 40 percent of cases). Postrenal acute renal failure occurs because of urinary tract obstruction (5 to 10 percent of cases).
Kidney failure is a condition in which one or both of the kidneys can no longer work on their own. This condition is also called renal failure. Treatments for kidney failure include dialysis and kidney transplant.
Severe diarrhea or vomiting can cause dehydration. A condition resulting from the excessive loss of water from the body. It is usually caused by severe diarrhea, vomiting or diaphoresis. A disorder characterized by excessive loss of water from the body.
signs of dehydration in babies and young children include a dry mouth and tongue, crying without tears, no wet diapers for 3 hours or more, a high fever and being unusually sleepy or drowsy.if you think you're dehydrated, drink small amounts of water over a period of time.
hemolytic anemias attributable to enzyme disorders ( D55.-) code (s) for any associated disorders of electrolyte and acid-base balance ( E87.-) A condition caused by the loss of too much water from the body. Severe diarrhea or vomiting can cause dehydration.
The 2022 edition of ICD-10-CM E86.0 became effective on October 1, 2021.
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.
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. Acute kidney failure/injury can be life threatening if severe as the kidneys can shut down.
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.
Once dehydration sets in, it can quickly start to affect many body organs. One of these is the kidneys. This can lead to acute renal/kidney failure/injury.
Dehydration results from excessive water loss from body tissues. Etiologies include but are not limited to extensive vomiting, diarrhea, gastroenteritis, renal or adrenal disease, diabetes mellitus, diuretic therapy, or having an ileostomy or colostomy.
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,
In Coding Clinic First Quarter 2019 page 12, AHA is now stating that there is no rule that acute renal/kidney failure/injury should always be sequenced first in these situations. They now are stating the sequencing of either dehydration or acute renal/kidney failure/injury should be based on the reason for admission. If it cannot be determined, or is not clearly documented, the physician should be queried.
When a patient presents with acute renal failure, treatment is directed at the underlying cause. The physician will restrict water intake and modify the diet to include high carbohydrate, low protein, and low potassium. If the kidney failure is severe, dialysis will be necessary to remove excess waste products.
Acute renal failure is the sudden loss of kidney function that occurs when the kidneys stop filtering waste products such as urea from the blood, causing them to accumulate. Acute renal failure is defined a significant decrease (greater than 50%) in glomerular filtration rate over a period of hours to days, with an accompanying accumulation of nitrogenous wastes in the body. It may result from a drastic drop in blood pressure that prevents enough blood from reaching the kidneys, a blockage of the blood vessels leading to the kidneys, or an obstructed urine flow after it leaves the kidneys.
In most instances, the acute renal failure is the more significant problem, which occasions the hospital admission. Therefore, since the admission is for treatment of the acute renal failure and not the underlying cause, it should be sequenced as the principal diagnosis ( AHA Coding Clinic for ICD-9-CM, 2002, third quarter, page 28).
However, once a patient develops end-stage renal disease (ESRD) and goes on chronic dialysis, acute renal failure is no longer an option. Patients with ESRD have no remaining functioning nephrons. Certain conditions (eg, rhabdomyolysis, gastrointestinal bleeding) may cause significant increases in creatinine that require more frequent dialysis but do not constitute acute renal failure as the kidneys are essentially dead.