Appendix.
Definition of Kidney and Cardiovascular Care.
| Category | Diagnostic codes defining cardiovascular-related care19-30 | Codes defining kidney-related care | ||||
|---|---|---|---|---|---|---|
| Ambulatory care claims | Codes description | ICD-9-CM | ICD-10 | Facility description | Location codes a | |
| Myocardial infarction | 410 | I21.xI22.x | HD specialty day/night care | 713408510 | ||
| Heart failure | 428 | I09.9 I11.0 I13.0 I13.2 I25.5 I42.0 I42.5 I42.6 I42.7 I42.8 I42.9 I43 I50.x P29.0 |
Home dialysis (teaching) | 713408520 | ||
| HHD (teaching) | 713408530 | |||||
| Home PD (teaching) | 713408540 | |||||
| Nephrology specialty clinic | 713501095 | |||||
| PD specialty day/night | 713408550 | |||||
| Renal dialysis specialty day/night care | 713408500 | |||||
| Cerebrovascular | 362.3 430 431 433 434 435 436 |
H34.1 I60.x I61.x I63.x I64.x G45.x |
Self-care HD specialty day/night | 713408560 | ||
| Hospitalization | Codes description | ICD-9 | ICD-10 | Codes description | ICD-9 | ICD-10 |
| Myocardial infarction | 410 | I21.x I22.x |
Type 1 diabetes mellitus with kidney complications | E102.1 E102.2 E102.9 |
||
| Heart failure | 428 | I09.9 I11.0 I13.0 I13.2 I25.5 I42.0 I42.5 I42.6 I42.7 I42.8 I42.9 I43 I50.x P29.0 |
Acute kidney failure | N17.0 N17.1 N17.2 N17.8 N17.9 |
||
| Chronic kidney disease | N18.0 N18.1 N18.2 N18.3 N18.5 N18.6 N18.9 |
|||||
| Cerebrovascular | 362.3 430 431 433 434 435 436 |
H34.1 I60.x I61.x I63.x I64.x G45.x |
Unspecified kidney failure | N19 | ||
| Postprocedural (acute) (chronic) kidney failure | N99.0 | |||||
| Extrarenal uremia | R39.2 | |||||
| Encounter for care involving renal dialysis | Z49.0 Z49.01 Z49.02 Z49.3 Z49.31 Z49.32 |
|||||
| Physician cost | Codes description | ICD-9 | ICD-10 | Claims description | Claims procedure code | |
| Myocardial infarction | 410 | I21.x I22.x |
PD catheter removal | 11.81A | ||
| Acute HD | 13.99A | |||||
| Heart failure | 428 | I09.9 I11.0 I13.0 I13.2 I25.5 I42.0 I42.5 I42.6 I42.7 I42.8 I42.9 I43 I50.x P29.0 |
Chronic HD | 13.99B | ||
| Assessment and management of an unstable patient with acute/chronic renal failure treated by PD | 13.99C | |||||
| Assessment and management of a stable patient with chronic renal failure treated by PD | 13.99D | |||||
| HD in ICD | 13.99AB | |||||
| Cerebrovascular | 362.3 430 431 433 434 435 436 |
H34.1 I60.x I61.x I63.x I64.x G45.x |
Weekly satellite/PD | 13.99OA | ||
| HHD | 13.99O | |||||
| Dialysis line insertion | 50.93A | |||||
| AVF creation | 51.27 | |||||
| PD catheter insertion | 66.98 | |||||
| AVF declot | 51.49A | |||||
| Fistulogram | 46.88 | |||||
Note. ICD-9-CM = International Classification of Diseases, Ninth Revision, Clinical Modification; ICD-10 = International Classification of Diseases, Tenth Revision; PD = peritoneal dialysis; HD = hemodialysis; HHD = home hemodialysis; AVF = arteriovenous fistula.
a
Location codes (rather than ICD-9/10 codes) were used to define kidney-related care; results using kidney-relevant ICD-9/10 codes revealed similar costing estimates.