I need some help with the diagnosis 250.4, DM w/renal manifestations, and the acute renal failure diagnosis 584.9. I know the 250.4 has to have the additional CKD code but when we are seeing patient in the hospital usually they are in acute renal failure. Would the acute code be primary then the 250.4 and CKD codes? Or if condition is not chronic then would the 250.4 take the 2ndary spot to the acute condition? Thanks!