ICD-10 CM Guideline Review: Chapter 14

Presenter

• Tiffany Roach, The Coding Coach

Purpose of the Presentation

• To review ICD-10 CM guidelines for Chapter 14: Diseases of the Musculoskeletal System and Connective Tissue (Codes M00-M99).
• Guidelines are effective for fiscal years 2024 and 2025.
• No changes from fiscal year 2024 to 2025.

Key Topic: Chronic Kidney Disease (CKD)

Classification of CKD

• CKD is classified based on severity:
  • Stage 1: Mild CKD
  • Stage 2: Code N18.2
  • Stage 3: Moderate CKD, Codes N18.30-N18.32
  • Stage 4: Severe CKD, Code N18.4
  • Stage 5: End-Stage Renal Disease (ESRD), Code N18.6

Guidelines for Coding CKD and ESRD

• If both a stage of CKD and ESRD are documented, only assign ESRD (Code N18.6).
• Post-kidney transplant, patients may still have CKD:
  • Do not assign a complication code.
  • Assign a code from category N18 for CKD stage.
  • Use Code Z94.0 for kidney transplant status.
• For transplant complications such as failure, refer to Chapter 19 guidelines.
• Query the provider if documentation about transplant complications is unclear.

CKD with Other Conditions

• When CKD is documented with other conditions (e.g., diabetes or hypertension),
  • Sequence CKD code based on tabular list conventions.

Conclusion

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