Chronic Renal Failure Is No More: New ICD-9 Codes For Chronic Kidney Disease

As of October 1, 2005, the phrases "chronic renal failure" and "chronic renal insufficiency" are now officially out of date. ICD-9 codes now reflect the new classification system for chronic kidney disease. From the Renal Physicians Association:

Code 585, Chronic renal failure, has been retitled and expanded to reflect the new clinical practice standard for treating what is now referred to as chronic kidney disease (CKD). The nonspecific term chronic renal failure has been used to mean any degree of kidney
failure including end stage renal disease (ESRD). It has also been used interchangeably with the nonspecific term chronic renal insufficiency. Based on the clinical practice guidelines developed by the National Kidney Foundation and supported by the Renal Physician Association, new codes have been created under new category 585, Chronic kidney disease, to classify the different stages of CKD.

Stage II, code 585.2, equates to mild CKD, stage III, code 585.3, equates to moderate CKD, and stage IV, code 585.4, equates to severe CKD. End stage renal disease (ESRD), code 585.6, is defined as stage V CKD with dialysis status. Because a patient who has stage V CKD cannot survive without dialysis, most stage V patients are ESRD patients. The terms chronic renal failure, chronic uremia, and chronic renal insufficiency are indexed to code 585.9, Chronic kidney disease, unspecified. Providers should be educated in the use and value of these new codes to greatly improve patient data. They should be encouraged to document the stage of CKD instead of using nonspecific terms.

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