Wiki Acute on Chronic Renal Disease

Community Wiki

This is a community-maintained wiki post containing the most important information from this thread. You may edit the Wiki once you have been on AAPC for 30 days and have made 5 posts. Learn More
Code: N18

Code Name: ICD-10 Code for Chronic kidney disease (CKD)

Block: Acute kidney failure and chronic kidney disease (N17-N19)

Excludes 2: congenital renal failure (P96.0)
drug- and heavy-metal-induced tubulo-interstitial and tubular conditions (N14.-)
extrarenal uremia (R39.2)
hemolytic-uremic syndrome (D59.3)
hepatorenal syndrome (K76.7)
postpartum hepatorenal syndrome (O90.4)
posttraumatic renal failure (T79.5)
prerenal uremia (R39.2)
renal failure complicating abortion or ectopic or molar pregnancy (O00-O07, O08.4)
renal failure following labor and delivery (O90.4)
renal failure postprocedural (N99.0)

Details: Chronic kidney disease (CKD)

Code first any associated:diabetic chronic kidney disease (E08.22, E09.22, E10.22, E11.22, E13.22)
hypertensive chronic kidney disease (I12.-, I13.-)

Use additional code to identify kidney transplant status, if applicable, (Z94.0)

Guidelines: Diseases of the genitourinary system (N00-N99)

Excludes 2: certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

For more details on N18, ICD-10 Code for Chronic kidney disease (CKD) , visit:


Best answers
Seeing this terminology on ER's. SO, do I code both the acute-593.9 and the chronic-585.9?:confused:


Best answers
If the patient is having an acute exacerbation of Chronic Kidney Disease (Chronic Renal Failure) than you should code the acute code first, then the chronic code.

Just be careful, many physicians interchange "Acute Renal Failure/Injury" and "Acute Renal Insufficiency" they are not the same and are coded different. So if you are unsure, query your physician to clarify which it is.
Cordelia, CCS, CPC
Last edited: