CCDS Acute Kidney Injury and Renal Documentation

Question 1

According to KDIGO criteria, Stage 1 AKI is defined as an increase in serum creatinine of at least how much within 48 hours?

Accepted Answer

0.3 mg/dL

Answer

0.1 mg/dL

Answer

0.5 mg/dL

Answer

1.0 mg/dL

Question 2

Which ICD-10-CM code for acute kidney injury is classified as a Major Complication or Comorbidity (MCC)?

Accepted Answer

N17.0 - Acute kidney failure with tubular necrosis

Answer

N17.9 - Acute kidney failure, unspecified

Answer

N18.4 - Chronic kidney disease, Stage 4

Answer

N18.6 - End-stage renal disease

Question 3

According to KDIGO urine output criteria, which finding is consistent with Stage 2 AKI?

Accepted Answer

Less than 0.5 mL/kg/hr for more than 12 hours

Answer

Less than 0.5 mL/kg/hr for more than 6 hours

Answer

Less than 0.3 mL/kg/hr for more than 24 hours

Answer

Anuria for 12 or more hours

Question 4

When a patient has both acute kidney injury and underlying chronic kidney disease documented, what is the correct ICD-10-CM coding approach?

Accepted Answer

Assign codes for both AKI and CKD to capture the complete clinical picture

Answer

Code only AKI since it is the more acute and significant condition

Answer

Code only the applicable CKD stage

Answer

Use a single combination code that covers both conditions without additional coding

Question 5

Which clinical indicator would most support a CDI query for acute kidney injury in a hospitalized patient?

Accepted Answer

Serum creatinine rise of 0.4 mg/dL above baseline within 36 hours

Answer

Serum creatinine of 0.9 mg/dL with a baseline of 0.8 mg/dL

Answer

Urine output of 600 mL over 8 hours in a 70 kg patient

Answer

Blood urea nitrogen of 15 mg/dL

Question 6

Which type of AKI etiology is most commonly associated with contrast-induced nephropathy?

Accepted Answer

Intrinsic (intrarenal) AKI from tubular injury

Answer

Pre-renal AKI due to volume depletion

Answer

Post-renal AKI from urinary obstruction

Answer

Functional AKI from low cardiac output

Question 7

Why is it important for CDI specialists to query for a specific type of acute kidney injury rather than accepting 'acute kidney failure, unspecified'?

Accepted Answer

Specific AKI types such as tubular necrosis are MCCs while unspecified AKI is only a CC

Answer

Stage-specific AKI codes have no impact on MS-DRG assignment

Answer

Staging is only required for CKD documentation, not AKI

Answer

Unspecified AKI always defaults to MCC status under MS-DRG grouping