EmailAcute kidney failure in a renal transplant patient
Publication Date: June 2018
ICD 10 AM Edition: Tenth edition
Query Number: 3364
In Ninth Edition an amendment was made to the classification regarding kidney transplant failure/kidney transplant status including Revision of ACS 1438 Chronic kidney disease to include the published classification advice regarding kidney transplant failure/kidney transplant status and addition of index entries to support code assignment.
Can VICC please provide guidance on how to code acute kidney failure in the following scenarios?
a) The patient was admitted with a fractured NOF, the patient's past history includes a renal transplant in 2010. During the admission the patient develops AKI (without documentation of kidney transplant failure)
b) The patient was admitted with a fractured NOF, the patient's past history includes a renal transplant in 2010. During the admission the patient develops AKI, documentation by nephrologist states the kidney transplant is not failing.
Do we follow the index entry below and assign T86.1 Kidney transplant failure and rejection?
Failure, failed/kidney/following/kidney transplant/acute T86.1
Or, in regards to the word following, do we apply ACS 1904 Procedural complications and only assign T86.1 Kidney transplant failure and rejection when documentation specifies a causal relationship? Therefore, should N17.9 Acute kidney failure, unspecified be coded?
Would Z94.0 Kidney transplant status also be appropriate to assign?
Search Details
ACCD References to changes for Ninth Edition 2015
Alphabetic Index
ACS 1904 Procedural complications
ACS 1438 Chronic kidney disease
Can VICC please provide guidance on how to code acute kidney failure in the following scenarios?
a) The patient was admitted with a fractured NOF, the patient's past history includes a renal transplant in 2010. During the admission the patient develops AKI (without documentation of kidney transplant failure)
b) The patient was admitted with a fractured NOF, the patient's past history includes a renal transplant in 2010. During the admission the patient develops AKI, documentation by nephrologist states the kidney transplant is not failing.
Do we follow the index entry below and assign T86.1 Kidney transplant failure and rejection?
Failure, failed/kidney/following/kidney transplant/acute T86.1
Or, in regards to the word following, do we apply ACS 1904 Procedural complications and only assign T86.1 Kidney transplant failure and rejection when documentation specifies a causal relationship? Therefore, should N17.9 Acute kidney failure, unspecified be coded?
Would Z94.0 Kidney transplant status also be appropriate to assign?
Search Details
ACCD References to changes for Ninth Edition 2015
Alphabetic Index
ACS 1904 Procedural complications
ACS 1438 Chronic kidney disease
Response
Kidney failure, kidney transplant status and kidney transplant failure are three separate diagnoses. Kidney failure can occur in a person with kidney transplant status without it necessarily being a complication of the kidney transplant or due to kidney transplant failure. There may be other causes of the kidney failure, such as dehydration.
In both the scenarios cited, follow the Index entry Failure/kidney/acute to assign N17.9 Acute kidney failure, unspecified.
The Index entry Failure/kidney/following/kidney transplant/acute would be followed to assign T86.1 Kidney transplant failure and rejection only if there was a causal relationship documented between the kidney failure and the kidney transplant as per ACS 1438 Chronic kidney disease, under the section Kidney transplant failure.
Z94.0 Kidney transplant status may also be assigned if it meets the criteria in ACS 0002 Additional diagnoses.
In both the scenarios cited, follow the Index entry Failure/kidney/acute to assign N17.9 Acute kidney failure, unspecified.
The Index entry Failure/kidney/following/kidney transplant/acute would be followed to assign T86.1 Kidney transplant failure and rejection only if there was a causal relationship documented between the kidney failure and the kidney transplant as per ACS 1438 Chronic kidney disease, under the section Kidney transplant failure.
Z94.0 Kidney transplant status may also be assigned if it meets the criteria in ACS 0002 Additional diagnoses.
