Wiki CKD in the setting of hypertension


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Working in a Nephrology group, many of our patients have some form of CKD secondary to HTN. My question is do I need to code the CKD along with the Hypertensive Kidney disease, Benign/Malig (5th digit indicating CKD stage) or can the 403-point whatever be coded alone to indicate CKD and HTN (to indicate cause-and-effect relationship)
You need both codes. In your code book, it specifically states " use additional code to identify the stage of CKD, 585.1-585.4, 585.9"

Cordelia, CCS, CPC
3. Hypertensive Chronic Kidney Disease with Chronic Renal
Assign codes from category 403, Hypertensive kidney
disease, when conditions classified to categories 585-587
are present. Unlike hypertension with heart disease,
ICD-9-CM presumes a cause-and-effect relationship and
classifies chronic kidney disease (CKD) with hypertension as
hypertensive chronic kidney disease.
Fifth digits for category 403 should be assigned as follows:
• 0 with CKD stage I through stage IV, or unspecified.
• 1 with CKD stage V or end stage renal disease.
The appropriate code from category 585, Chronic kidney
disease, should be used as a secondary code with a code from
category 403 to identify the stage of chronic kidney disease.
See Section I.C.10.a for information on the coding of
chronic kidney disease.