Summary Diagnosis ICD-10
Symptoms and SignsSummary DiagnosisChapter XIVN00-N39 Urinary Systemนพ.บริรักษ์ �นศัลยกรรม ��์ ysuriaHematuriaUrinary incontinenceUrinary retentionUrethral dischargeICD-10R34R35R35R30.0R31R32R33R36Oliguria: urine 400 ml/24 h; Anuria: urine 100 ml/24 h12Urinary Tract InfectionUrinary Tract InfectionFever UTI Acute pyelonephritisFever UTI Acute �เบียน ในผู้ใหญ่1. ��งทางเดินปัสสาวะ2. a (ปั่น): ผู้ชาย wbc 5 cells/HPF, ผู้หญิง wbc 10 cells/HPFBacteriuria: ไม่ปั่น 1 cells/HPF หรือ ปั่น 3 (moderate)3. หรือ �ชื้อปัสสาวะ: 105 �บียน ในเด็กเล็กก. ตรวจปัสสาวะพบ 2 ใน 3 ข้อ ดังต่อไปนี้- Pyuria: wbc 5 cells/HPF- Bacteria in gram stain: 1 /HPF- Nitrite and/or Leukocyte esteraseข. Urine culture 105 coloniesไม่ต้องบันทึก UTI ี่ชัดเจน เช่น Cystitis, �้อยกว่า 3 ปี ธี suprapubic aspiration หรือtransurethral catheterisation เท่านั้น34
Renal FailureChapter XIVN17-N19 Renal FailureN16.4* Renal tubulo-interstitial disorders in systemic connective tissuedisordersนพ.บริรักษ์ เจริญศิลป์Renal tubulo-interstitialdisorders ษ์ นครสวรรค์ sicca syndrome [Sj gren] ( M35.0 ) systemic lupus erythematosus ( M32.1 )N16.5* Renal tubulo-interstitial disorders in transplantrejection5( T86.- † )Acute Renal FailureAcute Kidney InjuryAcute Tubular NecrosisPrerenal AzotemiaChronic Kidney DiseaseRenal InsufficiencyOliguria: 400 ml/24 hours, Anuria 75 ml/hours [100 ml]6N16.8* Renal tubulo-interstitial disorders in other diseases classifiedelsewhereRenal failure(N17-N19)Use additional external cause code (Chapter XX), if desired, to identifyexternal agent.Excludes: congenital renal failure ( P96.0 )drug- and heavy-metal-induced tubulo-interstitial and tubularconditions ( N14.- )extrarenal uraemia ( R39.2 )haemolytic-uraemic syndrome ( D59.3 )hepatorenal syndrome ( K76.7 )· postpartum ( O90.4 )prerenal uraemia ( R39.2 )renal failure:· complicating abortion or ectopic or molar pregnancy( O00-O07 , O08.4 )· following labour and delivery ( O90.4 )· postprocedural ( N99.0 )N17N17.0Acute Kidney InjuryAcute renal failureIncludes: acute renal impairmentAcute renal failure with tubular necrosisTubular necrosis:· NOS· acute· renalIn ICD-10 system,‘Etiology' is the “First Priority”.7Version for 20108577
RIFLE Criteria & AKIN CriteriaAcute Renal FailureA clinical syndrome characterised by rapid reduction in renalexcretory function underpinned by variety of causedARF is defined by the glomerular filtration rate is reduced .decrease urine nitrogenous wasted accumulates in the body .uraemia metabolic and electrolytes disturbancesReserved for patients who have lost renal function tothe point that life can no longer be sustained withoutintervention and need renal replacement therapyAcute Dialysis Quality Initiative (ADQI) group 2003Acute Kidney Injury Network (AKIN) 2007910Acute Kidney InjuryAcute Kidney InjuryA clinical syndrome characterised by rapid reduction in renalexcretory function underpinned by variety of causedAKI causes are generally divided into Pre-renal Renal (intrinsic) Post-renalUsed to describe the milder as well as severe formsof acute renal dysfunction in patientsA clinical syndrome characterised by rapid reduction in renalexcretory function underpinned by variety of causedAcute Kidney Injury CriteriaAny of the following- Increase in serum creatinine 0.3 mg/dL within 48 hours- Increase in serum creatinine 1.5x baseline within 7 days- Urine volume 0.5 mL/kg/h x 6 hoursKDIGO 2012Kidney Disease Improving Global Outcome1112
AKI vs ARFAcute Renal FailureAKI ARF ?Acute Kidney InjuryAcute Renal FailureDefined as an abrupt change inserum creatinine and/or urine outputand classified according the RIFLEcriteria or AKIN criteriaDefined as renal function inadequateto clear the waste products ofmetabolism despite the absence ofcorrection of hemodynamic ormechanical causesIntended to describe the entirespectrum of disease from beingrelatively mild to severeClinical manifestations of renalfailure include the following- Uremic symptoms- Hyperkalemia- Hyponatremia- Metabolic acidosisPrerenal ARF: Functional disturbanceDecreased renal perfusion without cellular injuryPrerenal azotemia, Acute renal failure (unspecified)Renal-Intrinsic ARF: Structural damageProlonged renal ischemia, Nephrotoxicity, Infectious processesAcute tubular necrosis, Acute interstitial nephritis, Acuteglomerulonephritis, Vascular occlusionsPostrenal ARF: ObstructionObstruction to the urinary outflow1314Renal-Intrinsic Renal FailureAcute Tubular Necrosis ar 2%Ac glomerulonephritis Ac. tubular necrosisAc. interstitial nephritis Vascular Thrombotic microangiopathy- TTP- HUSCryoglobulinaemiaAnti-GBM diseaseDrug-induced- NSAIDs- antibioticsInfiltrative- lymphomaGranulomatous- sarcoidosis- tuberculosisInfection related- post-infective- pyelonephritisIschemiaToxin15Renal artery occlusionRenal vein thrombosisCholesterol emboliVasculitisIschaemic typeProlonged renal ischemiaToxic typeEndogenous toxinsRhabdomyolysisHaemolysisExogenous toxinsAntibiotics e.g. aminoglycosides, amphotericin BRadiocontrast agentsHeavy metals e.g. cis-platinum, mercuryPoisons e.g. ethylene glycol16
N13.7 Vesicoureteral-reflux-associated uropathyVesicoureteral reflux:· NOS· with scarringExcludes: reflux-associated pyelonephritis ( N11.0 )N13.8 Other obstructive and reflux uropathyN13.9 Obstructive and reflux uropathy, unspecifiedUrinary tract obstruction NOSNephrotoxic Renal FailureN14Acute Renal FailureDrug- and heavy-metal-induced tubulo-interstitialand tubular conditionsUse additional external cause code (Chapter XX), if desired, toidentify toxic agent.N14.0Analgesic nephropathyN14.1Nephropathy induced by other drugs, medicaments andbiological substancesNephropathy induced by unspecified drug, medicament orbiological substanceN14.2N14.3Nephropathy induced by heavy metalsN14.4Toxic nephropathy, not elsewhere classifiedVersion for 201017‘Risk’ in RIFLE criteria or ‘Stage 1’ in AKIN �ียน สปสช. 25621. มีการเพิ่มของ creatinine เพิ่มมากกว่าเดิม 0.3 �ิตร ภายในเวลา 48 ชั่วโมง หรือเพิ่มขึ้น 1.5 เท่าของเดิมภายใน 1 สัปดาห์2. �ลดลงน้อยกว่า 0.5 �มงนานกว่า 6 �ัยว่า Acute kidney injury (AKI) � Prerenal azotemia [R39.2] หรือ Acute renal failure [N17.9]57518Prerenal AzotemiaAcute Renal FailureReversible increase in serum creatinine and ureaRecommendation for Summary Record๏ ��เร็ว- BUN:creatinine ratio �า 20:1- Urine specific gravity มากกว่า 1.018๏ ��ใน 1–2 วัน๏ มักตรวจพบสาเหตุ เช่น การขาดน้ำ ท้องเสีย �หตุ �ักบันทึก Prerenal azotemia �วมR39.219๏ การบันทึก acute renal failure �� � ��ัวอย่างNSAIDs-induced renal failureContrast media-induced renal failureHaemolytic-uremic syndromeHepatorenal ึก Acute renal failure �วม‣ � ให้บันทึก Acute renal failure เป็นคำวินิจฉัย20
Acute-on-Chronic Renal FailureAcute Kidney InjuryNot for End Stage Renal DiseaseIntrinsic causedSummary Diagnosis๏ มีประวัติ Chronic kidney disease๏ �ลัน ตามเกณฑ์วินิจฉัย Acute renal failure- creatinine เพิ่มขึ้น 0.3 �ิตร ใน 48 ชั่วโมง หรือ- creatinine เพิ่มขึ้น 1.5 เท่า ในระยะเวลา 7 วันที่ผ่านมา- �ว่า 0.5 �มง นานกว่า 6 ชั่วโมง‣ บันทึก Acute renal failure �ักและบันทึก Chronic kidney disease �วมกรณี Acute-on-End stage renal diseaseไม่ต้องสรุป Acute renal failure 0Renal insufficiencyPrerenal azotemiaAcute kidney injuryAcute renal failureN19R39.2N17.9N17.9Acute tubular necrosis [ATN] – ischaemic causedNSAIDs-induced ATNRadiocontrast-induced ATN or renal failureAntibiotic-induced ATN or renal failureN17.0N14.0 Y45.N14.1 Y57.5N14.1 Y40.-AKI due to obstructive uropathyN17.8 N13.9Obstructive nephropathy N13.8 / Obstructive uropathy N13.92122Acute Kidney InjuryAcute Renal FailureExtrinsic causedSCG 2017Summary DiagnosisSLE with renal failureThrombotic thrombocytopenic purpura with renal failureHenoch-Schonlein purpura with renal failureHaemolytic-uremic syndromeHepatorenal syndromePostpartum hepatorenal syndromePostpartum renal failurePostoperative renal failureTraumatic anuria / Traumatic rhabdomyolysisICD-10M32.1 N08.5M31.1 N08.5D69.0 N08.2D59.3 �ให้รหัส N17.x �ัยร่วม23ARF with tubular necrosis ��ลงอย่างน้อย 1 สัปดาห์ �รวจพบ granular cast, renal epithelial cell castระดับ FeNa มากกว่าร้อยละ 1ARF with acute cortical necrosis ่า 2 สัปดาห์ ��ะไตวายเรื้อรังARF with medullary or papillary necrosis ��นของท่อไตโดย sloughed ischaemic papillaพบใน analgesic nephropathy, sickle cell nephropathy, nephritis DM24
Acute Renal FailureRenal Papillary NecrosisMore specific than N17.9Not found in ARF, onlyARF with tubular necrosis น้อย 1 ��มาดีขึ้นภายใน 1-2 สัปดาห์ARF with acute cortical necrosis ่า 2 สัปดาห์ ��ายเรื้อรังARF with medullary or papillary necrosis ��มาในปัสสาวะ �ในการตรวจ DiabetesNephrosclerosisAmyloidosisVasculitisRenal vein thrombosisShock, DehydrationRejection [kidney transplant]Urinary tract obstruction2526Renal Papillary NecrosisChronic Kidney DiseasePattern on ImagingChronic kidney disease (CKD) is defined based on the presenceof either kidney damage or decreased kidney function for three ormore months, irrespective of the causeCKD is defined by the presence of kidney damage or decreased kidney function for three or more months irrespective of the causeA. Normal; B. Ball-on-tee; C. Fornix excavation; D. Lobster claw; E. Signet ring; F. Clubbed calyx2728
Chronic Kidney DiseaseChronic kidney disease (CKD) is defined by the presence of kidney damage or decreased kidney functionKidney damage renal biopsy or imaging studies or inferred from markers such asa. urinary sediment abnormalities orb. increased rates of urinary albumin excretionDecreased kidney function glomerular filtration rate (GFR) 60 mL/min/1.73 m2Chronic Kidney DiseaseChronic kidney disease (CKD) is defined by the presence of kidney damage or decreased kidney functionImaging abnormalities U/S, CT, MRI, isotope scan, angiography Hydronephrosis due to obstruction Cortical scarring due to infarcts, pyelonephritis or reflux Renal masses or enlarged kidney due to infiltrative dis. Renal artery stenosis Small and echogenic kidneys in later stages of CKD Polycystic kidneys2930Chronic Kidney DiseaseChronic Kidney DiseaseChronic kidney disease (CKD) is defined by the presence of kidney damage or decreased kidney functionUrinary sediment abnormalities RBC casts in proliferative glomerulonephritis WBC casts in pyelonephritis or interstitial nephritis Oval fat bodies or Fatty casts in diseases with proteinuria Granular casts and renal tubular epithelial cellsAlbuminuriaalbumin excretion rate 30 mg in 24 hours Urine albumin-to-creatinine ratio 30 mg/g urine dipstick: trace or 1 Urine31Chronic kidney disease (CKD) is defined based on the presenceof either kidney damage or decreased kidney function for three ormore months, irrespective of the causeDiagnostic CriteriaDuration 3 months, based on documentation withGlomerular filtration rate (GFR) 60 mL/min/1.73 m2orKidney damage, as defined bystructural abnormalities orfunctional abnormalities other than decreased GFR32
Chronic Kidney DiseaseChronic Kidney DiseaseSummary DiagnosisChronic kidney diseaseChronic kidney disease stage 1Chronic kidney disease stage 2Chronic kidney disease stage 3Chronic kidney disease stage 4Chronic kidney disease stage 5End stage renal diseasewith kidney ��ั้ง3334Chronic Kidney DiseaseChronic Kidney DiseaseNo Code in ICD-10StageeGFR (mL/min/1.73 m2)GradeUrine A/C (mg/g)1 (G1)Normal or 90A1 302 (G2)60-89A230-3003 (G3a)45-59A3 3003 (G3b)30-444 (G4)15-295 (G5) 15 or DialysiseGFR: estimated glomerular filtration rateA/C: albumin/creatinine รื้อรัง: �จฉัยร่วมได้: e overload [E87.7]Uremic encephalopathy [G92]Uremic neuropathy [N18.5 G63.8]Uremic pericarditis [N18.5 rphosphatemiaHypocalcemiaHyperuricemiaMetabolic ��ร่งด่วน36
Chronic Renal FailureESRD PatientSCG 2017๏ �งไตวายเรื้อรัง เช่น hypertensive renal disease,diabetic nephropathy, lupus nephritis๏ � ��นี้: Peritoneal dialysis status หรือ CAPD status‣ นั้นเป็น๏ ฟอกเลือด ��นี้: Haemodialysis status หรือ Renal dialysis status: Arteriovenous fistula status หรือ AVF statusโรคหลัก‣ �� �ไตทางช่องท้อง �คราวนี้: Peritoneal dialysis care หรือ CAPD care ผู้ป่วยใน �ายเรื้อรัง ระยะที่ 4–5 ผู้ป่วยนอก �กระยะ๏ �ด �คราวนี้: Haemodialysis care3738ESRD PatientESRD PatientSummary DiagnosisICD-10Peritoneal dialysis status / CAPD statusHaemodialysis statusAVF statusZ99.2Z99.2Z99.2Haemodialysis carePeritoneal dialysis care / CAPD careZ49.1Z49.239Summary ProcedureVenous catheterisation for haemodialysisHaemodialysisArteriovenous shunt [AVF]Arteriovenous graft [AVG]ICD-9-CM38.9539.9539.2739.9340
Summary Diagnosis ICD-10 Renal insufficiency Prerenal azotemia Acute kidney injury Acute renal failure N19 R39.2 N17.9 N17.9 Acute tubular necrosis [ATN] – ischaemic caused NSAIDs-induced ATN Radiocontrast-induced ATN or renal failure Antibiotic-induced ATN or renal failure N17.0 N14.0 Y45.- N14.1 Y57.5 N14.1 Y40.-
ICD-9 724.02 ICD-10 M48.06 Spinal stenosis, lumbar region ICD-9 720.2 ICD-10 M46.1 Sacroiliitis, not elsewhere classified ICD-9 724.8 ICD-10 R29.898 Other symptoms and signs involving the ** musculoskeletal system ICD-9 721.42 ICD-10 M47.16 Other spondylosis with myelopathy, lumbar region ICD-9 723.1 ICD-10 M54.2 Cervicalgia ICD
More on ICD-10. ICD-10-PCS replaces ICD-9-CM inpatient procedure coding: ICD-9-CM procedure codes 3 to 4 numeric digits ICD-10-CM codes 7 alphanumeric digits ICD-10-PCS code format substantially different from ICD -9 Unlike ICD-9, ICD-10
ICD-10 Tips from PHCS The Road to ICD-10 Flyer AMA ICD-10 Project Plan Template Educational Tools Folder Precyse University ICD-10 Physician Office Solution Brochure Precyse Catalog of ICD-10 Courses ICD-10 Precyse Apps for Physicians Resources Folder Free Resources ICD-9 to ICD-10 Crosswalk of Most Common ICD-9 .
Dec 14, 2010 · ICD-9. ICD-10. ICD-9. ICD-10. Inactive. Active. Combined Code Set. Core Technologies. ICD-9 and ICD-10 code values are unique. Generally, the industry is taking one of two approaches as it relates to the ICD-10 transition: Remediation: Modify/expand all systems and processes to accommodate ICD-
ICD-10 to ICD-10-CM Based on FY2017 ICD-10-CM codes Category and subcategory codes are shaded in grey and marked with an Cells shaded in pink and marked with an *indicate the preferred code when a single code maps to multiple codes (see Introduction) Reportable Neoplasms . Type of Code ICD-10 Category Chapter II (Neoplasms) ICD-10 Term . ICD .
7/13/2015 1 Tonya Mitchell, RHIT July 17, 2015 Objectives Review the History of ICD‐10 Discuss the Myths and Facts of ICD‐10 Discuss GlGeneral DttiDocumentation CtConcepts Review ICD‐10 Documentation Concepts Analyze Documentation for Top Diagnosis in ICD‐10 WHY CHANGE FROM ICD‐9 TO ICD‐10? ICD‐9 was developed in the 1970s and cannot support current
Finding the ICD-10 equivalent for an ICD-9 code can be a challenge. This resource of frequently used codes can help when ordering an MRI from Shields. *Based on Shields MRI data ICD-10 Cheat Sheet Frequently Used ICD-10 Codes for Musculoskeletal Conditions* ICD-9 DIAGNOS
of the previous ICD-9 coding system. The volume of ICD-10 codes as compared to ICD-9 codes is significant because in ICD-10, the code size has been expanded, code values and interpretations have been redefined and specificity has been further improved. Global ICD-10 adoption The current version of ICD is ICD-10, which was adopted by the World .
