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Thread: DX code for AKI (Acute Kidney Injury)

  1. #1

    Red face DX code for AKI (Acute Kidney Injury)

    AAPC: Back to School
    I'm seeking help from anyone out there w/nephrology experience. What would be the correct dx code for AKI, Acute Kidney Injury. The ICD-9 book directs me to 866.00 however I do not feel comfortable using this code as it relates to more of a trauma type injury. My doc uses this dx frequently as it relates to patients with other health complications that have affected the kidney. I was considering possibly 593.9 but again am just not sure. I'm new to the Nephrology world!! Thank you in advance for any help you can provide!!

    Ellen Risotti, CPC

  2. #2
    Join Date
    Apr 2007


    You are right NOT to use 866.00. That is a trama injury to the kidney. I think your physician might mean ARF (Acute Renal Failure, 584.9). If a patient's creatinine is elevated because of other health complications, it might be ARF. But on the other hand, if a patient has had HTN for several years, or any other underlying disease that leads into CKD (chronic kidney disease) you would use the 585 codes.(585.1-585.5).
    Hope this helps!!

  3. #3
    Join Date
    Apr 2007
    Gulf Coast - GCAPC


    Just an FYI for you...

    It seems that "Acute Kidney Injury" is new terminology approved by the National Kidney Foundation instead of using "acute renal failure". Don't know why they wanted that - which has no diagnosis code attached to it. It was creating a lot of havoc w/ our coders, too.

    After asking the state coding quality foundation, they were stumped too because they said "terminology within specialties seems to change quicker than is indicated by terminology used to assign codes within ICD-9... It would be inapropriate to assign 584.9 when documentation is only 'acute kidney injury' "... Then they said we should submit this to the Coding Clinic since they were sure that we wouldn't be the only ones to face this concern.

    So, it seems that others are still in the same boat!! Sheesh!
    Rhonda Winder, CPC

  4. #4
    Join Date
    Apr 2007
    Duluth, Minnesota


    I was stumped on this one, "injury"... I think Kathyrod is correct and perhaps your providers need to change their verbiage when documenting the issues. (however, like I just stated in another post - good luck with getting that done) I would agree the trauma code would be wrong to use.

    rmwinder - wow! thanks for that info! sheesh is right!

    {that's my opinion on the posted matter}
    Donna, CPC, CPC-H

  5. #5

    Default acute kidney injury

    Glad to hear that others have the same frustrations! My facility has a new, young doctor, and I have been getting this diagnosis a lot. However, she seems to always state it as Acute Renal Failure WITH acute kidney injury. Hmmm. . .

  6. #6


    ICD-9 584, ICD-10 N17, synonyms: renal failure, acute renal failure, ARF, primary acute renal failure, ... Acute renal failure (ARF) or acute kidney injury (AKI), ...
    renal failure associated with burns or other trauma or with acute infection or obstruction of the urinary tract
    Synonym: acute kidney failure.renal failure associated with burns or other trauma or with acute infection or obstruction of the urinary tract
    Synonym: acute kidney failure.

    The lack of a standard definition for acute kidney injury has resulted in a large variation in the reported incidence and associated mortality. RIFLE, a newly developed international consensus classification for acute kidney injury, defines three grades of severity – risk (class R), injury (class I) and failure (class F) – but has not yet been evaluated in a clinical series.

  7. #7
    Join Date
    Apr 2007
    Sioux Falls South Dakota


    ICD9-CM: 584.9 Acute kidney failure, unspecified
    Acute kidney injury (nontraumatic)
    Excludes [I] traumatic kidney injuey (866.0-866.13)[I]

    Our nephrologists have been using the terminology of AKI instead of ARF for some time. Since the ICD9-CM does have it listed under acute kidney failure, we use the 584.9 if they are not more specific by telling us if there is a lesion and where.

    Hope this helps,
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  8. #8
    Join Date
    Apr 2007

    Default Coding Clinic Re: Acute Kidney Injury


    There is a coding clinic that address this, CC 3Q 2011 pg 16. And it says 584.9 IS appropriate. In my encoder, Trucode, under 584.9 Acute Kidney Failure, Unspecified, it lists ACUTE KIDNEY INJURY(NONTRAUMATIC)

    Hope this helps,
    Shari, RN, CPC-A

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