Every year, “World Kidney Day (WKD)” is celebrated on March 12 (2nd Thursday of March) worldwide. Created in the year 2006, as a joint initiative between the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations (IFKF), WKD aims to spread awareness about kidney-related diseases and the importance of kidneys with regard to the overall health of a person. It also highlights the urgent need for preventive measures that help to reduce the frequency and impact of chronic kidney diseases and related health problems on a global scale.
Chronic kidney disease (CKD) is widely recognized as a global public health problem and is characterized as the gradual loss of kidney function. The growing prevalence of CKD is estimated to be 8-16% worldwide. According to the Centers for Disease Control and Prevention (CDC), this disease is recognized as the 9th leading cause of death in the United States. It is estimated that about 20 million adults (more than 10%) suffer from CKD and most are undiagnosed.
Celebrated worldwide, “World Kidney Day” is a global platform that brings together millions of people in over 150 countries to generate a powerful voice for kidney health awareness. The theme for the 2015 event is – “Kidney Health for All.” This event educates people about the potential risks and complications associated with this disease and how to prevent them effectively through a healthy lifestyle, early detection and routine screening.
Since its inception in 2006, this health awareness campaign has become a global phenomenon wherein thousands of patients, healthcare professionals, healthcare authorities and decision makers will take action to raise awareness about this deadly condition by hosting countless local and national events such as seminars, fundraising events, public discussions and education events to make the general public understand the importance of preventive measures and early treatment.
When CKD reaches an advanced stage, high levels of fluid, electrolytes and wastes build up in your body. Generally, patients may experience few signs and symptoms in the early stages of this disease. The signs and symptoms develop gradually until the organ function is impaired significantly. The associated symptoms include nausea, loss of appetite, vomiting, fatigue and weakness, changes in urine output, swelling of feet and ankles, high blood pressure, shortness of breath (if fluid builds up in the lungs), and hiccups. The prominent risk factors include diabetes, hypertension and genetics.
If detected at an early stage, CKD is often treatable. Early detection of symptoms facilitates effective treatment that can prevent the disease from getting worse or reaching advanced stages. Urologists play an important role in understanding and preventing the challenges faced by CKD patients. For early detection of symptoms, these physicians recommend regular standard screening tests such as urine tests, blood tests, imaging tests and removing a sample of kidney tissue for testing. These routine tests will help patients to better manage the disease symptoms, thereby enhancing patient function. In addition, it will help to identify the disease in its early stages and begin treatment in order to reduce the chances of complications.
Documenting CKD Accurately
It is important for urologists to correctly document their diagnosis and preventive measures they perform so that during the medical coding process, coders can assign appropriate diagnostic and procedure codes.
- 585 – Chronic kidney disease (CKD)
- 585.1 – Chronic kidney disease, Stage I
- 585.2 – Chronic kidney disease, Stage II (mild)
- 585.3 – Chronic kidney disease, Stage III (moderate)
- 585.4 – Chronic kidney disease, Stage IV (severe)
- 585.5 – Chronic kidney disease, Stage V
- 585.6 – End-stage renal disease
- 585.9 – Chronic kidney disease, unspecified
In ICD-10-CM, CKD is classified on the basis of severity as follows:
- N 18.1 chronic kidney disease, stage 1
- N 18.2 chronic kidney disease, stage 2 (mild)
- N 18.3 chronic kidney disease, stage 3 (moderate)
- N 18.4 chronic kidney disease, stage 4 (severe)
- N 18.5 chronic kidney disease, stage 5
- N 18.6 End stage renal disease
- N18.9 Chronic kidney disease, unspecified
Coding Diabetic Chronic Kidney Disease
More than one code is required to diagnose diabetic chronic kidney disease. This comprises one combination code that signifies the type of diabetes with CKD and one that indicates the stage of CKD. The user has to code first any associated diabetic chronic kidney disease using the following codes.
- E 08.22 Diabetes mellitus due to underlying condition with diabetic chronic kidney disease
- E 09.22 Drug or chemic induced diabetes mellitus with diabetic chronic kidney disease
- E 10.22 Type I diabetes mellitus with diabetic chronic kidney disease
- E 11.22 Type II diabetes mellitus with diabetic chronic kidney disease
- E 13.22 Other specified diabetes mellitus with diabetic chronic kidney disease
Coding Hypertensive Chronic Kidney Disease
Hypertensive chronic kidney disease is coded using more than one code in ICD-10 – one combination code that signifies that the patient has both hypertension and CKD and one that indicates the stage of CKD. Hypertension codes are available in Chapter 9 of ICD-10, under Diseases of Circulatory System (100 – 199). When a patient has hypertensive chronic kidney disease and acute renal failure, an additional code has to be used for indicating acute renal failure.
Let Us Join Hands to Spread Awareness about CKD
Spreading awareness about CKD is the key to effectively managing this condition. Let us regard “World Kidney Day” as the perfect opportunity to get out in the community, share the message and generate awareness of the risk factors for this deadly disease with friends, family and other people we meet.