ICD 10 CM Chapter Specific Guidelines I. C14

Dr. Lisa L Campbell®
11 Feb 201904:44
EducationalLearning
32 Likes 10 Comments

TLDRThis video script focuses on ICD-10-CM Chapter 14, which deals with diseases of the genital urinary system, specifically chronic kidney disease (CKD). It explains the coding guidelines for CKD based on severity stages one to five, and how to code for CKD with end-stage renal disease (ESRD), kidney transplant status, and complications. The script also discusses the importance of considering co-existing conditions like diabetes and hypertension when coding CKD, highlighting the need to refer to the ICD-10-CM tabular list and alphabetical index for accurate code assignment.

Takeaways
  • 📚 ICD-10-CM Chapter 14 focuses on diseases of the genital urinary system, specifically chronic kidney disease (CKD).
  • 📈 CKD is classified based on severity, with stages ranging from one (mild) to five (end-stage renal disease).
  • 🌟 If ESRD (End-Stage Renal Disease) is documented alongside a CKD stage, only the ESRD code (N18.6) should be assigned.
  • 💡 Post-kidney transplant patients may still have CKD; the presence of CKD alone does not indicate a transplant complication.
  • 🔄 For patients with CKD and a kidney transplant, assign the CKD stage code and use Z9T4.0 to indicate transplant status.
  • 📝 If a transplant complication is documented, refer to Section 1, Guideline 19G for coding complications of a kidney transplant.
  • 🔍 In unclear cases regarding transplant complications, seek clarification from the healthcare provider.
  • 🤝 CKD patients may also have other conditions like diabetes and hypertension, and their codes should be sequenced according to the ICD-10-CM tabular list.
  • 🔑 The ICD-10-CM alphabetical index under diabetes and hypertension provides specific codes for these conditions in conjunction with CKD.
  • 🌐 Examples of combined codes include E11.22 for type 2 diabetes with CKD and guidelines for hypertension and CKD were reviewed in Chapter 9.
Q & A

  • What is the focus of Chapter 14 in the ICD-10-CM tabular list?

    -Chapter 14 focuses on diseases of the genital urinary system, specifically chronic kidney disease (CKD).

  • How is chronic kidney disease classified in the ICD-10-CM code set?

    -Chronic kidney disease is classified based on severity, which is designated by stages one through five.

  • What are the ICD-10-CM codes for different stages of chronic kidney disease?

    -Stage two is coded as N18.2, stage three as N18.3, stage four as N18.4, and stage five as N18.6.

  • What should be done if both a stage of CKD and End-Stage Renal Disease (ESRD) are documented?

    -Assign the code for stage N18.6 when both a stage of CKD and ESRD are documented.

  • Can patients who have undergone a kidney transplant still have chronic kidney disease?

    -Yes, patients may still have some form of CKD because the transplant may not fully restore kidney function.

  • How is the presence of CKD in relation to a kidney transplant coded?

    -Use code N18 for the stage of CKD and Z9T4.0 to indicate kidney transplant status.

  • What happens if a transplant complication is documented?

    -Refer to Section 1, Guideline 19G for coding complications of a kidney transplant.

  • How is the sequencing of the CKD code determined in relation to other conditions?

    -The sequencing is based on the ICD-10-CM tabular list and the specific codes available for conditions like diabetes and hypertension.

  • What is a specific example of a code that combines CKD with another condition?

    -An example is E11.22, which is type 2 diabetes with CKD.

  • Where should one look for specific codes related to CKD and other conditions like diabetes and hypertension?

    -In the ICD-10-CM alphabetical index, under the main terms like diabetes and hypertension, pay attention to the subterms and interest codes available.

  • What was discussed in the Chapter 9 review video?

    -The guidelines for hypertension and CKD were reviewed in the Chapter 9 review video.

Outlines
00:00
📘 Introduction to ICD-10-CM Chapter 14: Genital Urinary System Diseases

This paragraph introduces the viewer to ICD-10-CM Chapter 14, which focuses on diseases of the genital urinary system. It emphasizes that not all 21 chapters in the ICD-10-CM tabular list have specific guidelines. The chapter specifically addresses chronic kidney disease (CKD) and uses the ICD-10-CM code set to classify CKD based on severity, designated by stages one through five. The paragraph explains the coding for different stages of CKD, highlighting that if both a stage of CKD and end-stage renal disease (ESRD) are documented, only the ESRD code (18.6) should be assigned.

💡 Chronic Kidney Disease and Kidney Transplant Status

This section discusses the coding guidelines for patients with chronic kidney disease who have undergone a kidney transplant. It clarifies that a kidney transplant may not fully restore kidney function, and thus, the presence of CKD alone does not indicate a transplant complication. The correct coding practice is to assign the CKD stage code (18.-) and use Z9T4.0 to indicate kidney transplant status. If a transplant complication is documented, additional guidelines (section 1, guideline 19G) should be consulted. The paragraph also advises querying the provider for clarification if the documentation is unclear regarding transplant complications.

🌟 Sequencing CKD with Other Conditions and Hypertension/Diabetes Coding

The paragraph addresses the sequencing of CKD codes in relation to codes for other coexisting conditions, such as diabetes and hypertension. It instructs coders to refer to the ICD-10-CM tabular list for proper sequencing and to pay close attention to the alphabetical index under diabetes and hypertension for specific codes that indicate the presence of both conditions. For instance, E11.22 is a code for type 2 diabetes with CKD. The paragraph also references previous guidelines discussed in Chapter 9 for hypertension and CKD, encouraging viewers to review those for a comprehensive understanding.

🎓 Conclusion of Chapter 14 and Transition to Chapter 15

The speaker concludes the review of Chapter 14, wishing the viewers happy coding and transitions to the next topic, which is Chapter 15 on pregnancy. This sets the stage for the next section of the video, indicating a shift in focus to a different area of medical coding.

Mindmap
Keywords
💡ICD-10-CM
ICD-10-CM stands for the International Classification of Diseases, 10th Revision, Clinical Modification. It is a coding system used in the United States for medical billing and reporting purposes. In the video, it is mentioned as the basis for classifying chronic kidney disease based on severity and assigning codes for various conditions related to the genital urinary system.
💡Chronic Kidney Disease (CKD)
Chronic Kidney Disease, or CKD, is a long-term condition where the kidneys are damaged and cannot function properly over time. The severity of CKD is classified into stages, ranging from one to five, with five being the most severe. In the context of the video, the focus is on the guidelines for coding CKD in the ICD-10-CM system.
💡Stages of CKD
The stages of CKD represent the progression of the disease, with each stage indicating a different level of kidney function loss. Stage one is the earliest and least severe, while stage five is the most severe, often requiring dialysis or a kidney transplant. The video script outlines the specific ICD-10-CM codes for each stage of CKD, emphasizing the importance of accurate coding based on the severity of the disease.
💡End-Stage Renal Disease (ESRD)
End-Stage Renal Disease, or ESRD, is the final stage of chronic kidney disease, where the kidneys have lost function to the point that they can no longer sustain life without dialysis or a kidney transplant. In the video, it is mentioned that when both a stage of CKD and ESRD are documented, the code for ESRD (18.6) should be assigned.
💡Kidney Transplant
A kidney transplant is a surgical procedure where a person with kidney failure receives a healthy kidney from a donor. In the context of the video, it is important to note that patients who have undergone a kidney transplant may still have some form of CKD, and the presence of CKD alone does not indicate a transplant complication.
💡Transplant Complication
A transplant complication refers to any adverse event that occurs as a result of a transplant procedure. In the context of the video, if a complication related to a kidney transplant is documented, specific coding guidelines under section 1, guideline 19G of the ICD-10-CM are to be followed.
💡Sequencing of CKD Code
Sequencing of the CKD code refers to the order in which codes for CKD and other co-existing conditions are reported. This is based on the ICD-10-CM tabular list and the specific rules for coding such conditions. The video emphasizes the importance of following these rules for accurate medical billing and reporting.
💡Diabetes and Hypertension
Diabetes and hypertension are common chronic conditions that can co-exist with CKD. These conditions can affect the management and treatment of CKD, and it is important for healthcare providers to accurately report these co-morbidities using the appropriate ICD-10-CM codes.
💡Coding Guidelines
Coding guidelines are the rules and instructions that healthcare providers and coders must follow to accurately classify and report medical conditions using the ICD-10-CM coding system. These guidelines ensure consistency and precision in medical billing and record-keeping.
💡Medical Billing
Medical billing is the process of submitting claims to insurance companies for payment of healthcare services provided to patients. Accurate coding is crucial in this process to ensure proper reimbursement for services. The video script emphasizes the importance of following ICD-10-CM coding guidelines for accurate medical billing related to chronic kidney disease and other conditions.
💡Provider Queries
Provider queries refer to the practice of healthcare coders or billers asking the healthcare provider for clarification when medical documentation is unclear or incomplete. This is done to ensure that the medical records are coded accurately, which is essential for proper billing and patient care.
Highlights

Introduction to ICD-10-CM chapter 14 focusing on diseases of the genital urinary system.

Chronic kidney disease (CKD) is the primary focus of chapter 14 with codes ranging from N00 through N99.

CKD severity is classified into stages one to five, with stage two (N18.2) being mild and stage three (N18.3) moderate.

Stage four (N18.4) is severe CKD, and stage five (N18.6) indicates end-stage renal disease (ESRD).

When both CKD stage and ESRD are documented, only the ESRD code (N18.6) should be assigned.

Patients with a kidney transplant may still have CKD, so CKD alone does not indicate a transplant complication.

For coding, assign the CKD stage code followed by Z9T.4.0 to indicate kidney transplant status.

If a transplant complication is documented, refer to section 1, guideline 19G for coding complications of a kidney transplant.

Patients with CKD may also have other conditions like diabetes and hypertension, and the sequencing of codes is based on the ICD-10-CM tabular list.

Use the ICD-10-CM alphabetical index for specific codes related to diabetes and hypertension with CKD.

There is a specific code (E11.22) for type 2 diabetes with CKD.

Guidelines for hypertension and CKD were reviewed in chapter 9.

The importance of querying the provider for clarification when documentation is unclear regarding transplant complications.

The conclusion of the chapter 14 review and a transition to the next section, chapter 15 on pregnancy.

Transcripts

Browse More Related Video

ICD-10-CM BootCamp: Diseases of the Genitourinary System

2023 ICD 10 CM CODING GUIDELINES FOR Chapter 14 Diseases of Genitourinary System N00 N99

Chronic Kidney Disease (CKD) | Etiology, Pathophysiology, Clinical Features, Diagnosis, Treatment

Chronic Renal Failure (Kidney Disease) Nursing | End Stage Renal Disease Pathophysiology NCLEX

ICD 10 CM Guidelines Section 1. A

ICD 10 CM Chapter Specific Guidelines I. C9

Rate This

5.0 / 5 (0 votes)

Thanks for rating:

Related Tags
Medical CodingChronic Kidney DiseaseKidney TransplantICD-10-CM GuidelinesSeverity StagingTransplant ComplicationsDiabetes & CKDHypertension & CKDCoding SequencingHealthcare Industry