The ICD-10-CM code for Chronic Kidney Disease (CKD) Stage 3 (N18. 3) has been revised for Fiscal Year 2021.
ICD-10 Code for Type 2 diabetes mellitus with diabetic chronic kidney disease- E11. 22- Codify by AAPC.
It is true you wouldn't code both. Diabetic nephropathy is a specific subset of CKD. It is an advanced renal disease due to microvascular damage from hyperglycemia, manifested by proteinuria.
N18. 3 - Chronic kidney disease, stage 3 (moderate). ICD-10-CM.
HCC 138 – Chronic Kidney Disease, Moderate (Stage 3)
ICD-Code E11* is a non-billable ICD-10 code used for healthcare diagnosis reimbursement of Type 2 Diabetes Mellitus. Its corresponding ICD-9 code is 250. Code I10 is the diagnosis code used for Type 2 Diabetes Mellitus.
E11. 22, Type 2 diabetes mellitus with diabetic CKD.
CKD is most likely related to both hypertension and diabetes when the patient has all three conditions. Both high blood sugar and high pressure in the blood vessels will cause the vessels to deteriorate, which can then damage the kidneys.
21 and E11. 22 have an excludes 1 notes therefore they can be coded together as long as a separate renal manifestation is present, I would just be careful when coding the actual renal condition as there are some renal codes that are excluded when using CKD codes.
N18. 31- Chronic Kidney Disease- stage 3a. N18. 32- Chronic Kidney Disease- stage 3b.
Stage 3a means you have an eGFR between 45 and 59, and Stage 3b means you have an eGFR between 30 and 44.
Coders have been advised to code “CKD” (any stage, or without mention of a stage) to N03. 9, and also to code any concurrent mention of renal failure or impairment (chronic or unspecified) to N18. - or N19 as appropriate.
Type 2 diabetes mellitus (T2DM) is associated with central obesity, which promotes carcinogenesis through the secretion of proinflammatory cytokines by visceral adipose tissue [18]. Obesity is often associated with liver cirrhosis and liver fibrosis progression [44], a primary risk factor for HCC [45].
HCC coding for DiabetesFOR diabetes (type 2)USEwith other circulatory conditionsE11.59 DM with other circulatory conditionswith hyperglycemiaE11.65 DM with hyperglycemiawith CKDE11.22 DM with CKDwith PAD/PVDE11.51 DM with PAD/PVD7 more rows•Sep 23, 2021
E11. 22 states within its code DM with CKD therefore it is a more accurate code than E11. 21 which is just DM with Nephropathy (any kidney condition).
HCCs, or Hierarchical Condition Categories, are sets of medical codes that are linked to specific clinical diagnoses. Since 2004, HCCs have been used by the Centers for Medicare and Medicaid Services (CMS) as part of a risk-adjustment model that identifies individuals with serious acute or chronic conditions.
For gestational diabetes (diabetes that occurs during pregnancy) women should be assigned a code under the 024.4 subheading and not any other codes under the 024 category.
If the type of diabetes that the patient has is not documented in the medical record, E11 codes for type 2 diabetes should be used as a default. If the medical record doesn’t say what type of diabetes the patient has but indicates that the patient uses insulin, the Type 2 diabetes codes should also be used.
The “unspecified” codes can be used when not enough information is known to give a more specific diagnosis; in that case, “unspecified” is technically more accurate than a more specific but as yet unconfirmed diagnosis. For more guidelines on using ICD-10 codes for diabetes mellitus, you can consult this document.