Earlier stages of kidney disease can often be detected only through laboratory testing. Measurement of serum creatinine (with estimation of GFR) and urinary albumin can identify patients with reduced kidney function. Screening asymptomatic individuals at increased risk could allow earlier detection of chronic kidney disease.

Therapeutic interventions at earlier stages of chronic kidney disease are effective in slowing the progression of chronic kidney disease. The major therapeutic strategies that have been tested include strict blood glucose control in diabetes, strict blood pressure control, angiotensin-converting enzyme (ACE) inhibitors and angiotensin-receptor blockers, and dietary protein restriction.

  • To improve documentation to support the code, calculate and state the specific stage. Avoid using ranges which are not specific.
  • Designate acute or chronic. One abnormal lab test does not diagnosis chronic kidney disease. For CKD, lab tests need to be repeated over three months to indicate chronic illness.
  • Indicate if the patient is on dialysis.  Coding guidelines state a dialysis patient is automatically coded to ESRD (585.6).
  • Document the underlying cause if known, such as diabetes mellitus or hypertension, and link to the kidney disease using the adjective form , e.g, hypertensive, diabetic.
  • Support the diagnosis with test results, consult reports, symptoms, patient teaching, etc., in the visit notes.  Do not code a condition that was not addressed in the visit; instead, address the condition, however briefly, and then code it.

National Kidney Foundation Online Resources