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v1.0.0
ICD-10 Guide
DiagnosesAcute Kidney Injury

Acute Kidney Injury

ICD-10 Coding for Acute Kidney Injury(N17.0, N17.1, N17.2, N17.8, N17.9)

PRIMARY SPECIALTYNephrology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Acute Kidney Injury?
Essential facts and insights about Acute Kidney Injury

Key Clinical Considerations:

  • Acute rise in serum creatinine levels (≥0.3 mg/dL within 48 hours or ≥1.5 times baseline within the prior 7 days)
  • Oliguria (urine output <0.5 mL/kg/hour for more than 6 hours)
  • Signs of fluid overload (e.g., edema, hypertension)
  • Electrolyte imbalances (e.g., hyperkalemia, metabolic acidosis)
  • Potentially reversible causes identified (e.g., dehydration, nephrotoxic agents)

Clinical Information

Clinical Criteria & Documentation Requirements

  • Document the patient's baseline kidney function and any changes observed
  • Use specific terminology such as 'acute kidney injury' or 'AKI' in the medical record
  • Examples include: 'Patient presents with acute kidney injury secondary to dehydration' or 'Serum creatinine increased from 1.0 to 2.5 mg/dL'
  • Document medical necessity for tests and treatments related to AKI
  • Include quality measures such as urine output monitoring and serum creatinine tracking

Coding Guidelines

Usage Guidelines & Examples

  • Use N17.0 for AKI due to acute tubular necrosis, N17.1 for AKI due to prerenal causes, and N17.2 for AKI due to postrenal causes
  • Do NOT use these codes for chronic kidney disease or acute-on-chronic kidney failure
  • N17.8 is for other specified acute kidney failure, while N17.9 is for unspecified acute kidney failure
  • Common errors include misclassifying AKI as chronic kidney disease; ensure documentation supports acute diagnosis
  • In complex cases, consider the underlying cause and document all contributing factors clearly

Code Exclusions

Important Exclusions

  • Exclude chronic kidney disease (N18) and end-stage renal disease (N18.6)
  • Use N17.9 for unspecified cases when the cause is not determined
  • Conditions like acute glomerulonephritis (N00-N03) are distinct and should not be coded as AKI
  • Avoid common mistakes such as coding AKI when the patient has chronic kidney disease without acute exacerbation
  • Related conditions include acute tubular necrosis and prerenal azotemia, which have specific coding requirements

Related ICD-10 Codes

Primary Codes
N17.0
Acute kidney failure due to acute tubular necrosis
N17.1
Acute kidney failure due to prerenal causes
N17.2
Acute kidney failure due to postrenal causes
N17.8
Other specified acute kidney failure
N17.9
Acute kidney failure, unspecified
Differential Codes
N17.9
N17.9
when no specific cause of AKI is documented.
N17.0
N17.0
when tubular necrosis is documented.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Nephrology

Specialty Applications

  • Patients with acute illness, dehydration, or exposure to nephrotoxins
  • All age groups, but particularly at risk are the elderly and those with pre-existing kidney conditions
  • Clinical settings include inpatient hospitalizations, emergency departments, and outpatient nephrology clinics
  • Nephrology specialists often manage AKI cases, especially those requiring dialysis
  • Treatment contexts include acute management of fluid overload and electrolyte imbalances

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Template 1

Template: 'Patient diagnosed with acute kidney injury based on elevated serum creatinine levels.'

Template 2

Template: 'Clinical presentation consistent with acute kidney injury including oliguria and fluid overload.'

Template 3

Template: 'Diagnostic criteria for acute kidney injury met as evidenced by a serum creatinine increase of 1.5 times baseline.'

Template 4

Template: 'Treatment plan initiated for acute kidney injury with intravenous fluids and electrolyte management.'

Template 5

Template: 'Follow-up care for acute kidney injury including monitoring of renal function and urine output.'

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What documentation is required for this diagnosis?

Document changes in kidney function, symptoms, and any underlying causes.

How does this differ from similar diagnoses?

AKI is characterized by a rapid decline in kidney function, while chronic kidney disease is a gradual process.

What are common billing considerations?

Ensure medical necessity is documented for tests and treatments related to AKI.

What procedures are typically associated?

Commonly associated procedures include renal ultrasound and dialysis.

Are there any quality reporting implications?

Quality measures include monitoring serum creatinine and urine output in AKI patients.