ARF due to

[Jenr0406]

I'm trying to figure out how to code acute renal failure due to dehydration. I've searched under the kidney failure icdp but all the due to's do not list dehydration. Since it is the cause of the ARF Im not sure if I should use 2 dx's or not.

 

[balamuruganm]

Yes

You should use both the diagnosis because there is no cause and relationship with both diagnosis, code first AKI and followed by dehydration

 

[Happylife]

I agree with Balamurugan, code both condition.

 

[Indignation]

Both diagnosis codes should be coded.

Coding Clinic 3rd Q 02

Question:

Acute Renal Failure Due to Dehydration



Question: A patient is admitted with acute renal failure (ARF) due to severe dehydration. The patient is treated with IV fluids and a renal ultrasound reveals atrophic right kidney. The patient slowly improves; however, the family does not want aggressive work-up and the patient is discharged to a hospice. What is the principal diagnosis in this case, ARF or dehydration?



Answer: Assign code 584.9, Acute renal failure, unspecified, as the principal diagnosis. Acute renal failure was the reason for the admission. Code 276.5, Volume depletion, should be assigned as an additional diagnosis.



Question: In cases similar to the above, when a patient is admitted with acute renal failure (ARF) due to dehydration, but only IV hydration is performed and BUN and creatinine return to normal (no renal work-up and no renal disease is noted), would the principal diagnosis change? Does the fact that renal work-up was or was not done affect the sequencing?



Answer: Assign code 584.9, Acute renal failure, unspecified, as the principal diagnosis. Acute renal failure was the reason for the admission. Code 276.5, Volume depletion, should be assigned as an additional diagnosis. The fact that renal function was not investigated or worked up does not affect code assignment.