Proper functioning of the kidneys is critical for good health. Every year, March is observed as National Kidney Month to spread awareness about the importance of kidney health.  Nephrologists and other specialists treating kidney disease can benefit from outsourced billing services to report the condition correctly on medical claims.

According to kidney.org, 1 in 3 American adults is at high risk for developing kidney disease today.  It is estimated that 37 million people in the US have chronic kidney disease (CKD). Up to 9 in 10 people are not aware that they have CKD (www.niddk.nih.gov). High blood pressure, diabetes, a family history of kidney failure and being over 60 are major risk factors for developing kidney disease.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) aims to raise awareness and focus on “building paths to better kidney care” during  National Kidney Month 2022.

To prevent kidney disease, the National Kidney Foundation recommends taking proactive steps such as managing high blood pressure, consuming healthy food and drinks, and reducing stress.

Treatment for kidney disease usually focuses on controlling the underlying cause of the disease such as managing blood pressure, blood sugar, and cholesterol levels. Diagnosis tests that are recommended to check whether kidneys are functioning properly are – Ultrasound and CT scans, Glomerular filtration rate (GFR), Kidney biopsy, Blood creatinine test, and Urine test.

With expertise in nephrology medical billing, our team is up to date with the ICD and CPT codes related to kidney disease. To prevent claim denials and delays, practices need to assign the appropriate codes when billing their services.

ICD-10 codes to report kidney disease

Chronic kidney disease

  • N18 Chronic kidney disease (CKD)
    • 1 Chronic kidney disease, stage 1
    • 2 Chronic kidney disease, stage 2 (mild)
    • 3 Chronic kidney disease, stage 3 (moderate)
    • 4 Chronic kidney disease, stage 4 (severe)
    • 5 Chronic kidney disease, stage 5
    • 6 End stage renal disease
    • 9 Chronic kidney disease, unspecified

Kidney stones

  • N20 Calculus of kidney and ureter
    • 0 Calculus of kidney
    • 1 Calculus of ureter
    • 2 Calculus of kidney with calculus of ureter
    • 9 Urinary calculus, unspecified

Glomerulonephritis

  • N04.0  Nephrotic syndrome with minor glomerular abnormality
  • N04.1  Nephrotic syndrome with focal and segmental glomerular lesions
  • N04.2  Nephrotic syndrome with diffuse membranous glomerulonephritis
  • N04.3  Nephrotic syndrome with diffuse mesangial proliferative glomerulonephritis
  • N04.4  Nephrotic syndrome with diffuse endocapillary proliferative glomerulonephritis
  • N04.5  Nephrotic syndrome with diffuse mesangiocapillary glomerulonephritis
  • N04.7  Nephrotic syndrome with diffuse crescentic glomerulonephritis
  • N04.A  Nephrotic syndrome with C3 glomerulonephritis

Polycystic kidney disease

  • Q61.1 Polycystic kidney, infantile type
    • Q61.11 Cystic dilatation of collecting ducts
    • Q61.19 Other polycystic kidneys, infantile type
  • Q61.2 Polycystic kidney, adult type
  • Q61.3 Polycystic kidney, unspecified

Urinary tract infection

  • N39.0 Urinary tract infection, site not specified

IgA Nephropathy

  • N02.8 Recurrent and persistent hematuria with other morphologic changes

Lupus Nephritis

  • M32.14 Glomerular disease in systemic lupus erythematosus

Cystinosis

  • E72.04 Cystinosis

Nephrology coding requires proper documentation of diverse treatment information such as – anatomic site specificity, laterality, the severity of the disease, the onset of care, aetiology and manifestation, etc.

Factors that affect practice reimbursement include: too many days in accounts receivable, assigning wrong codes in claims, failing to document a history of present illness, increasing number of claims denial rates, not following up claims, and not appealing for once denied claims. Outsourcing billing, coding and claim submission tasks to a HIPAA compliant medical billing company is a practical way to ensure a smooth billing and revenue cycle.

Discuss your requirements with OSI’s coding team! Call us at 1-800-670-2809!

We provide comprehensive medical billing and coding services for all specialities, ranging from front office administrative management to insurance verifications and authorizations, back office coding, billing and collection.

As the nation observes National Kidney Month, physicians can educate patients on the three ways the NIDDK recommends to build their personalized path to better kidney care:

  • Be an active participant in your care.
  • Follow your care plan.
  • Build a kidney healthy lifestyle.

As they focus on patient care and education, providers can rely on our professional nephrology medical coding support to ensure accurate claim submission.