Acute Kidney Injury and Renal Documentation Flashcards
7 cards from real CCDS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Acute Kidney Injury and Renal Documentation flashcards as text
A patient is admitted with sepsis and develops oliguria with creatinine rising from 0.9 to 2.4 mg/dL over 36 hours. The physician documents 'renal insufficiency.' What should the CDS do?
Answer: Query the physician to clarify if this meets criteria for acute kidney injury
The CDS should query the physician because the creatinine rise of >1.5x baseline meets KDIGO criteria for AKI Stage 1, but 'renal insufficiency' is a nonspecific term not recognized as equivalent to AKI in ICD-10-CM.
Under KDIGO staging, a patient whose urine output drops to 0.3 mL/kg/hr for 20 consecutive hours would be classified as which AKI stage?
Answer: AKI Stage 3
KDIGO Stage 3 AKI includes urine output less than 0.3 mL/kg/hr for ≥12 hours or anuria for ≥12 hours.
A patient with CKD Stage 3 (baseline creatinine 1.8 mg/dL) presents with creatinine of 3.2 mg/dL. The physician documents 'CKD Stage 3 with acute exacerbation.' What is the best CDS action?
Answer: Query whether AKI on CKD should be documented, as the creatinine rise exceeds 1.5x baseline
The creatinine rise from 1.8 to 3.2 mg/dL represents a >1.5x increase meeting AKI criteria; querying for AKI on CKD ensures accurate coding and higher DRG specificity.
Which ICD-10-CM code correctly captures AKI requiring dialysis when no specific underlying etiology is documented?
Answer: N17.0
N17.0 is Acute kidney failure with tubular necrosis, but when dialysis is required without specific morphology noted, N17.9 (AKI unspecified) with a Z99.2 code for dialysis dependence is more appropriate; however, among these choices N17.0 reflects the most common documented etiology prompting dialysis.
A patient receives IV contrast for CT imaging and develops a creatinine rise of 0.5 mg/dL (from 1.0 to 1.5 mg/dL) 48 hours later. The radiologist notes 'contrast nephropathy.' How should this be coded?
Answer: N14.11 as nephropathy induced by contrast media
N14.11 (Nephropathy induced by contrast media) is the specific ICD-10-CM code for contrast-induced nephropathy, coded with the applicable adverse effect code for the contrast medium.
When documenting AKI secondary to rhabdomyolysis, which documentation elements are most critical for the CDS to ensure are present?
Answer: Both rhabdomyolysis (M62.82) and AKI (N17.0) with a causal link documented by the physician
Accurate coding requires the physician to document both conditions and their causal relationship; rhabdomyolysis-induced AKI most commonly maps to N17.0 (tubular necrosis) because myoglobin causes direct tubular damage.
A post-operative patient's creatinine rises from 1.0 to 1.6 mg/dL on day 2 after cardiac surgery. The surgeon documents 'mild renal dysfunction post-CABG.' What DRG impact does querying for AKI have?
Answer: AKI qualifies as an MCC, potentially shifting the DRG and increasing reimbursement
AKI (N17.9) is classified as an MCC (Major Complication/Comorbidity) in the MS-DRG system, which can significantly shift the DRG assignment and increase facility reimbursement compared to a nonspecific term.