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v1.0.0
ICD-10 Guide
ICD-10 CodesN28.0

N28.0

Billable

Ischemia and infarction of kidney

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

Code Description

ICD-10 N28.0 is a billable code used to indicate a diagnosis of ischemia and infarction of kidney.

Key Diagnostic Point:

Ischemia and infarction of the kidney refer to conditions where there is a reduction in blood flow to the kidney, leading to tissue damage or necrosis. This can occur due to various factors, including renal artery occlusion, systemic hypotension, or embolic events. The kidney's vascular supply is crucial for its function, and ischemic nephropathy can result from chronic conditions such as atherosclerosis or acute events like renal artery thrombosis. Symptoms may include flank pain, hematuria, and renal dysfunction. Diagnosis typically involves imaging studies such as Doppler ultrasound or CT angiography to assess blood flow and identify any obstructions. Management may include addressing the underlying cause, such as anticoagulation for embolic events or surgical intervention for vascular occlusions. Understanding the nuances of ischemic nephropathy is essential for accurate coding and appropriate patient management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between ischemia and infarction
  • Identifying underlying causes (e.g., embolism, thrombosis)
  • Need for imaging studies to confirm diagnosis
  • Potential for co-existing renal conditions

Audit Risk Factors

  • Inadequate documentation of ischemic events
  • Failure to specify the cause of ischemia
  • Misclassification of acute vs. chronic conditions
  • Lack of imaging results in the medical record

Specialty Focus

Medical Specialties

Nephrology

Documentation Requirements

Detailed clinical notes on renal function tests, imaging studies, and treatment plans.

Common Clinical Scenarios

Patients presenting with acute renal failure, flank pain, or hematuria.

Billing Considerations

Ensure that all imaging and lab results are included to support the diagnosis.

Emergency Medicine

Documentation Requirements

Thorough documentation of patient history, physical examination findings, and immediate interventions.

Common Clinical Scenarios

Patients with acute abdominal pain and suspected renal ischemia.

Billing Considerations

Rapid assessment and documentation are critical for timely intervention.

Coding Guidelines

Inclusion Criteria

Use N28.0 When
  • According to ICD
  • 10 guidelines, N28
  • 0 should be used when there is clear documentation of ischemia or infarction of the kidney
  • It is important to include the cause of the ischemia when known

Exclusion Criteria

Do NOT use N28.0 When
  • Exclude codes for conditions that are not directly related to ischemia or infarction

Related ICD-10 Codes

Related CPT Codes

76775CPT Code

Ultrasound, abdomen, real time with image documentation; complete

Clinical Scenario

Used to evaluate renal blood flow in suspected ischemia.

Documentation Requirements

Document indications for ultrasound and findings.

Specialty Considerations

Nephrologists may require additional imaging for comprehensive assessment.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of renal conditions, including ischemia and infarction, which aids in better tracking and management of these conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of renal conditions, including ischemia and infarction, which aids in better tracking and management of these conditions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of renal conditions, including ischemia and infarction, which aids in better tracking and management of these conditions.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the primary cause of ischemia in the kidney?

The primary cause of ischemia in the kidney is often related to vascular occlusion, which can be due to embolism, thrombosis, or systemic hypotension.