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Acute on Chronic - How many of you code

  1. #1
    Question Acute on Chronic - How many of you code
    Medical Coding Books
    How many of you code to "chronic" when you see a diagnosis of --

    Acute on chronic renal failure?

  2. #2
    Default Renal Failure
    Take a look at this article
    Acute Renal Failure With Chronic Renal Failure
    Occasionally, medical record documentation may state the patient was admitted with acute-on-chronic renal failure, meaning there was an exacerbation of the chronic status, which may have been indicated by a rise in the creatinine level. Another condition such as dehydration may have caused the exacerbation. In this case, it is appropriate to assign a code for both the acute renal failure (584.9) and chronic renal failure (585.9).
    Heather Winters, CPC, CFPC

  3. #3
    Thanks Heather

  4. #4
    Default Article
    No problem, hope it helps
    Heather Winters, CPC, CFPC

  5. #5
    Albany, Oregon
    Quote Originally Posted by Gemini18 View Post
    How many of you code to "chronic" when you see a diagnosis of --

    Acute on chronic renal failure?
    We always code the ESRD/CKD in addition to any acute renal failure. Try to be as specific as possible when coding CKD. If your MD does not provide the level of CKD, look for the most recent lab study of MORD GFR. The result will guide you to the appropriate code. (Yeah... I code this a lot!)
    Hope this is helpful!

    Pat Kidd, CPC

  6. #6
    Columbia, MO
    Also if you look to the guidelines for coding and reporting of ICD-9 it states to code both the acut and the chronic and to sequnce first the one being treated.

    Debra A. Mitchell, MSPH, CPC-H

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