AKI with CHF + CKD + HTN

jmccorkl@stanfordhealthcare.org

Please help with sequencing rules:

Pt admitted with Acute Kidney Injury and Acute on Chronic Congestive Heart Failure  - history of Chronic Kidney Disease and Hypertension.  
Code N179 (Acute kidney injury) and I130 (Hypertensive heart & chronic kidney disease) meet criteria for Principal diagnosis and are supported in the documentation.

Is there a reason why N179 cannot be PDx in the presence of I130 ?

Thank you everyone!

Jeanne McCorkle BSN, RN, CCDS

smfaisalhussain@hotmail.com

Hi Jeanne,

I don't find any reason CODING wise that would prevent you from using AKI as PDx. However, as you very well know, selection of PDx depends on clinical circumstances, and focus of treatment.

Hope this answered your question.

Faisal Hussain, MD, CCDS, CDIP

noelv20

I concur, Pdx should be based on the acuity, condition that occasioned the admission & a supporting guideline or coding clinic (if it exist).

pandjbennett@charter.net

question, patient admitted w Fluid overload, Acute CHF, Hyperkalemia and ESRD missed Dialysis. Per coder must be Fluid overload as PDx then ESRD as SDx, not Hypetensive heart and renal as PDx stated coding guideline.  I am unable to locate this guideline.  Can someone please help locate?  Thank you.