CCDS Acute Kidney Injury and Renal Documentation 2

Question 1

Which CKD stage corresponds to a GFR of 15–29 mL/min/1.73m²?

Accepted Answer

Stage 4

Answer

Stage 3a

Answer

Stage 3b

Answer

Stage 5

Question 2

Which ICD-10-CM code is assigned for end-stage renal disease (ESRD) requiring renal replacement therapy?

Accepted Answer

N18.6

Answer

N18.5

Answer

N17.9

Answer

N19

Question 3

A patient with type 2 diabetes mellitus is documented with CKD Stage 3b. What is the correct ICD-10-CM coding approach?

Accepted Answer

Assign E11.22 for diabetic chronic kidney disease plus N18.32 for the specific CKD stage

Answer

Assign E11.9 and N18.32 as unrelated diagnoses

Answer

Assign only N18.32 since CKD is the complicating condition

Answer

Assign only E11.9 since diabetes is the underlying cause

Question 4

According to ICD-10-CM guidelines, what relationship is assumed between hypertension and chronic kidney disease when both are documented?

Accepted Answer

A causal relationship is assumed, requiring combination codes from category I12

Answer

Hypertension and CKD are coded separately as unrelated conditions

Answer

The physician must explicitly state that hypertension caused the CKD before linking them

Answer

Hypertension is coded as a complication of CKD rather than its cause

Question 5

What does the clinical term 'acute-on-chronic kidney disease' indicate for ICD-10-CM coding purposes?

Accepted Answer

AKI superimposed on pre-existing CKD, requiring codes for both conditions

Answer

A patient with CKD who has never experienced an acute kidney episode

Answer

CKD that has recently advanced to a higher stage without an acute episode

Answer

A temporary improvement in CKD function following treatment

Question 6

Which laboratory finding is most consistent with pre-renal acute kidney injury?

Accepted Answer

BUN-to-creatinine ratio greater than 20:1

Answer

Urine sodium greater than 40 mEq/L

Answer

Fractional excretion of sodium (FENa) greater than 2%

Answer

Urine specific gravity less than 1.010

Question 7

When reviewing a medical record, which finding would most prompt a CDI specialist to initiate a query for a renal diagnosis?

Accepted Answer

Documentation of 'elevated creatinine' without any corresponding renal diagnosis

Answer

Documentation of 'renal insufficiency' with creatinine trending downward to normal

Answer

A creatinine of 1.0 mg/dL in a patient with a known baseline of 0.95 mg/dL

Answer

Documentation of CKD Stage 2 with GFR confirmed at 65 mL/min