Wiki AKI on CKD

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SWsibemom

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If a patient has CKD stage 4 and comes in with AKI on CKD, how would you code this? The provider wants to code it as N17.9, N18.9 (for AKI on CKD) and N18.4. My thought since stage 4 is known, there is no need for N18.9 since N18.4 is coded to the highest specificity. Thank you for your suggestions.
 
You are correct. Per Section I.A.9.b of the ICD-10 guidelines: "Codes titled “unspecified” are for use when the information in the medical record is insufficient to assign a more specific code" so you would not assign N18.9 if you have documentation that supports assigning N18.4 in that same record.
 
I agree. I have quoted the guidelines to this physician, but she still thinks 2 CKD codes are needed. Thank you for your response.
 
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