Split Out Your Coding for Chronic Kidney Disease

There have been some ICD-9 coding changes for chronic kidney disease (CKD) medical billing. In mid-2006, CMS revamped the CKD diagnosis coding section and now, if your practice treats a patient that suffers from CKD, you will need to use one of the stage specific codings the 585.1-585.5 series.

Here are the CKD diagnosis codes that CMS wants you to use in 2006:

* 585.1–Chronic kidney disease, stage I. Use this code for patients who have kidney damage with normal or increased glomerular filtration rate (GFR), greater than or equal to 90 ml/min/1.73m.

* 585.2–… stage II (mild). This code represents kidney damage with mild decrease in GFR, 60-89 ml/min/1.73m.

* 585.3–… stage III (moderate). List this code when the patient has a moderate decrease in GFR, 30-59 ml/min/1.73m.

* 585.4–… stage IV (severe). In this case, there has been a severe decrease in GFR, 15-29 ml/min/1.73m.

* 585.5–… stage V. You’ll need this code for two conditions: kidney damage with GFR of less than 15 ml/min/1.73m, or kidney failure with GFR less than 15 ml/min/1.73m (if the patient isn’t on dialysis).

A quick medical billing tip to get these codings committed to memory quickly is to notice that the 585 category’s fourth digits simply specify in chronological order the five CKD stages from least severity (stage I) to greatest (stage V). So, if the medical notes say the patient has stage IV CKD, you would list code 585.4.

View all Articles by: Melissa Clark, CCS-P