Nephrology practices manage chronic kidney disease, end-stage renal disease, dialysis, electrolyte disorders, and kidney transplant follow-up. Accurate ICD-10 coding and ESRD billing are critical for Medicare reimbursement under the ESRD Prospective Payment System. This page covers the top codes used by nephrologists in the US.
N18.3 is Chronic kidney disease, stage 3. CMS further delineates N18.31 (Stage 3a, GFR 45–59) and N18.32 (Stage 3b, GFR 30–44) for specificity. Always code to the most specific stage supported by the GFR value documented in the chart.
What is the correct code for ESRD?
N18.6 is End-Stage Renal Disease. It is required for all ESRD patients on dialysis. Add Z99.2 (dependence on renal dialysis) as an additional code when applicable. ESRD patients are covered under Medicare Part B regardless of age.
When should I use I12 vs I10?
When hypertension and CKD coexist, code I12.9 (hypertensive CKD, stage 1–4) or I12.10 (with stage 5 CKD or ESRD). Do not code I10 and N18.x separately — ICD-10 convention assumes a causal relationship between hypertension and CKD.
What CPT code is used for dialysis?
90935 covers hemodialysis with one physician evaluation. 90937 is used when multiple physician evaluations occur during a hemodialysis session. Peritoneal dialysis uses 90945 (single evaluation) or 90947 (multiple evaluations).
How does OmniMD support nephrology practices?
OmniMD’s Nephrology EHR includes CKD staging calculators, eGFR tracking, ESRD monthly capitation billing tools, and integrated lab result feeds from major dialysis centers.
Streamline Your Nephrology Practice with OmniMD
Purpose-built EHR, billing, and practice management for Nephrology practices.
