N17-N19 — Acute kidney failure and chronic kidney disease
ICD-10-CM codes N17-N19 cover acute kidney failure and chronic kidney disease, within diseases of the genitourinary system. The block holds 18 codes across 3 categories, of which 15 are billable and 3 are header codes that cannot be submitted on a claim.
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- congenital renal failure (P96.0)
- drug- and heavy-metal-induced tubulo-interstitial and tubular conditions (N14.-)
- extrarenal uremia (R39.2)
- hemolytic-uremic syndrome (D59.3-)
- hepatorenal syndrome (K76.7)
- postpartum hepatorenal syndrome (O90.41)
- posttraumatic renal failure (T79.5)
- prerenal uremia (R39.2)
- renal failure complicating abortion or ectopic or molar pregnancy (O00-O07, O08.4)
- renal failure following labor and delivery (O90.41)
- renal failure postprocedural (N99.0)
Risk adjustment in N17-N19
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 326 Chronic Kidney Disease, Stage 5
- HCC 329 Chronic Kidney Disease, Moderate (Stage 3, Except 3B)
- HCC 327 Chronic Kidney Disease, Severe (Stage 4)
- HCC 328 Chronic Kidney Disease, Moderate (Stage 3B)
What else to watch in N17-N19
- 15 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.