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Membership Update: Tips for capturing chronic kidney disease

CDI Strategies, December 10, 2015

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To understand how to appropriately assign codes for chronic kidney disease (CKD) and acute kidney injury (AKI), instead of just reporting the codes that correspond with each and every note in the record, coders need to take a closer look at the clinical picture. Generally speaking, people with AKI are more likely to develop CKD in later years, and people with CKD are more likely to develop AKI.

“A lot of this relationship is modified by the severity of AKI, the stage of CKD, the duration of AKI, and the number of episodes,” says Garry L. Huff, MD, CCS, CCDS, AHIMA-approved ICD-10-CM/PCS trainer and president of Enjoin, formerly Huff DRG Review, in Eads, Tennessee.

This may start to sound like alphabet soup if coders don’t take the time to investigate what is actually going on with the patient and query the physician when necessary.

Whether the documentation notes decreased kidney function, the presence of radiographic or biochemical evidence of kidney damage, or a glomerular filtration rate (GFR) of less than 60 ml/min/1.73m2, CKD is established only when this abnormality persists for at least three months.

And it’s important to understand the difference between acute and chronic: If the patient has AKI, that means the condition is reversible; CKD means that it’s not reversible.

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