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v1.0.0
ICD-10 Guide
ICD-10 CodesN18.2

N18.2

Billable

Chronic kidney disease, stage 2 (mild)

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/18/2025

Code Description

ICD-10 N18.2 is a billable code used to indicate a diagnosis of chronic kidney disease, stage 2 (mild).

Key Diagnostic Point:

Chronic kidney disease (CKD) stage 2 is characterized by a mild decrease in kidney function, with an estimated glomerular filtration rate (eGFR) ranging from 60 to 89 mL/min/1.73 m². Patients in this stage may not exhibit significant symptoms, but they are at an increased risk for progression to more severe stages of CKD. The condition is often identified through routine blood tests that measure serum creatinine levels and calculate eGFR. Management typically involves controlling underlying conditions such as hypertension and diabetes, dietary modifications, and regular monitoring of kidney function. Patients may also be educated about the importance of lifestyle changes to slow the progression of kidney disease. Early intervention is crucial to prevent complications such as acute kidney injury (AKI), which can occur due to various factors including dehydration, nephrotoxic medications, or acute illnesses. Dialysis and renal replacement therapy are not typically required at this stage, but careful monitoring is essential to assess any changes in kidney function over time.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for accurate eGFR calculation and interpretation
  • Differentiation from other stages of CKD
  • Documentation of comorbid conditions affecting kidney function
  • Potential for progression to more severe stages requiring different codes

Audit Risk Factors

  • Inadequate documentation of eGFR
  • Failure to document comorbid conditions
  • Misclassification of CKD stage
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Nephrology

Documentation Requirements

Detailed documentation of kidney function tests, comorbidities, and treatment plans.

Common Clinical Scenarios

Management of patients with mild CKD, monitoring progression, and adjusting medications.

Billing Considerations

Ensure all lab results are included in the medical record to support coding.

Primary Care

Documentation Requirements

Routine monitoring of kidney function, documentation of risk factors, and patient education.

Common Clinical Scenarios

Screening for CKD in at-risk populations and managing chronic conditions.

Billing Considerations

Document lifestyle modifications and patient adherence to treatment plans.

Coding Guidelines

Inclusion Criteria

Use N18.2 When
  • Follow official ICD
  • CM guidelines for coding CKD, including the use of additional codes for associated conditions such as hypertension or diabetes
  • Ensure accurate documentation of eGFR and any relevant lab results

Exclusion Criteria

Do NOT use N18.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

80048CPT Code

Basic metabolic panel

Clinical Scenario

Used to monitor kidney function in CKD patients.

Documentation Requirements

Document lab results and interpretation.

Specialty Considerations

Nephrologists may require more detailed lab analysis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of CKD stages, improving the accuracy of patient records and facilitating better management of chronic conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of CKD stages, improving the accuracy of patient records and facilitating better management of chronic conditions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of CKD stages, improving the accuracy of patient records and facilitating better management of chronic conditions.

Resources

Clinical References

  • •
    Kidney Disease: Improving Global Outcomes (KDIGO)

Coding & Billing References

  • •
    Kidney Disease: Improving Global Outcomes (KDIGO)

Frequently Asked Questions

What is the significance of eGFR in diagnosing CKD stage 2?

eGFR is a critical measure of kidney function, and values between 60-89 mL/min indicate stage 2 CKD. Accurate calculation and documentation of eGFR are essential for proper coding and management.