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Old 07-27-2011, 11:31 AM
cpccoder2008 cpccoder2008 is offline
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Default Acute-on-chronic renal failure

My doctore is documenting Acute-on-chronic renal failure, the patient has a history of CRF, should this be coded 5859 and 593.9 ?
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Old 07-27-2011, 12:10 PM
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Originally Posted by cpccoder2008 View Post
My doctore is documenting Acute-on-chronic renal failure, the patient has a history of CRF, should this be coded 5859 and 593.9 ?
I would say 584.9, 585.9 - sequence the acute first, then the chronic. 593.9 is for acute renal disease, not failure...Hope that helps!
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Old 07-27-2011, 12:11 PM
meganrveach meganrveach is offline
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I agree with Brandi. We code 584.9 then 585.9.
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Old 07-27-2011, 01:02 PM
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What about acute on chronic renal insuffiency ?
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Old 07-27-2011, 01:08 PM
cordelia cordelia is offline
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Chronic Renal Insufficiency codes out the same as Chronic Renal Failure or Chronic Kidney Disease, so code 585.9 (unless the physician indicates which stage it is in, then code to the stage) and 593.9 for the Acute Renal Insufficiency, the ARI should be sequenced first.

My physicians interchange ARI and ARF all the time and I have to ask them to clarify which the patient has, so you might want to verify as well.
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Old 07-27-2011, 04:16 PM
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Originally Posted by cpccoder2008 View Post
What about acute on chronic renal insuffiency ?
Kimberlina's right - if it's insufficiency instead of failure, your primary code changes to 593.9, and the secondary stays 585.9. I noticed the difference between acute and chronic ICD-9 designations for failure vs. disease/insufficiency when I was looking this up the first time - I thought it was odd that there would be separate entries for renal failure and renal disease if it was acute, but not if it's chronic. It's like the people that made the code set thought, "Eh, who cares if it's a disease or if it's failing? Chronic Kidney problems are all the same...just stick them all under 585.9"
My guess is it has something to do with the CKD w/stages codes being there. I'm no nephrology expert, but this has made me curious - are the two really all that different?
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Old 07-28-2011, 03:24 PM
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Now i understand, nephrology is new to me so i'm still learning, thanks
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