welcome to the Legacy education icd10 CM guideline review series I am Tiffany roach the coding coach and I will be walking through the icd10 CM guidelines with you this video will cover the chapter specific guidelines for chapter 14 which is diseases of the muscular skeletal system and connective tissue represented by codes m00 through m99 this presentation is designed to review the icd10 CM guidelines that are effective for both fiscal year 2024 and 2025 there were no changes to the guidelines from fiscal year 2024 to 2025 guidelines for chapter 14 only addresses chronic kidney disease chronic kidney disease or CKD is classified based on the severity of the disease which is designated by stages 1 through 5 in 18.2 should be assigned for mild CKD or stage 2 n830 through 32 should be assigned for moderate CKD or stage three n18.4 should be assigned for severe CKD or stage 4 n18.6 should be assigned when the provider has documented in stage renal disease or ESRD if both a stage of CKD and ESRD are documented you should only assign ESRD or code n18.6 when a patient undergoes a kidney transplant they may still have some form of CKD because the transplanted kidney may not fully restore the kidney function a complication code should not be assigned in this instance you should assign a code from category n18 for the stage of CKD and code z94 0 for the kidney transplant status if a complication is present such as a transplant failure you should see chapter 19 guidelines for information on coding complications of a kidney transplant if the documentation is unclear if the patient has a complication of the transplant the provider should be queried when a patient has CKD and another serious condition such as diabetes or hypertension the sequencing of the CKD code and the other condition code should be based on the conventions of your tabular list as always thank you for supporting us and stay tuned for new videos in our icd10 CM guideline review please make sure to subscribe to our channel so that you can be in the know of our newest videos as they are released