2025 ICD-10-CM code N18.4
Chronic kidney disease, stage 4 (severe).
Medical necessity for the diagnosis and management of chronic kidney disease, stage 4 is established by the presence of a significantly reduced eGFR (15-29 mL/min/1.73 m²) and associated clinical manifestations.Treatment is necessary to slow disease progression, manage complications, and improve the patient's quality of life.
The physician is responsible for diagnosing the stage of chronic kidney disease based on the patient's eGFR, managing the patient's condition through medication, dietary modifications, and lifestyle changes, and coordinating care with specialists such as nephrologists, as needed. Regular monitoring of kidney function and other related health indicators is crucial.
In simple words: Stage 4 chronic kidney disease is a serious condition where your kidneys are severely damaged and not working as well as they should.This means waste products can build up in your body, and you may experience various symptoms. Regular medical care is essential to manage the disease and slow its progression.
Severe chronic kidney disease, stage 4, characterized by significantly reduced kidney function and an estimated glomerular filtration rate (eGFR) between 15 and 29 mL/min/1.73 m².This stage represents a serious decline in kidney function, requiring close monitoring and management to prevent progression to end-stage renal disease.
Example 1: A patient with a history of hypertension and type 2 diabetes presents with fatigue, swelling in the ankles, and decreased urine output. Blood tests reveal an eGFR of 20 mL/min/1.73 m², indicating stage 4 chronic kidney disease., A patient with a long-standing history of chronic kidney disease is experiencing worsening symptoms, including nausea, loss of appetite, and difficulty sleeping.Recent blood work shows a decline in eGFR to 25 mL/min/1.73 m², confirming progression to stage 4., A routine check-up on a patient with known kidney disease reveals an eGFR of 18 mL/min/1.73 m². The patient is asymptomatic but now requires closer monitoring and education regarding treatment options for stage 4 CKD.
Documentation should include the patient's eGFR, symptoms, relevant medical history (e.g., hypertension, diabetes), treatment plan, and any complications.Regular laboratory results, including creatinine and blood urea nitrogen (BUN) levels, are essential.
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- Specialties:Nephrology, Internal medicine, Family medicine
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Rural Health Clinic, Federally Qualified Health Center