ICD Code N18.4

ICD code N18.4 is chronic kidney disease, stage 4, which means the patient has severe loss of kidney function with an estimated glomerular filtration rate (eGFR) between 15 and 29 mL/min/1.73m².

1. Evidence of chronic kidney disease for at least three months

2. Estimated glomerular filtration rate (eGFR) between 15 and 29 mL/min/1.73 m²

3. Persistent reduction in kidney function not attributable to acute kidney injury

4. Laboratory findings indicating severe decrease in kidney function

5. Possible symptoms may include fatigue, edema, changes in urination, and complications such as anemia or bone disease

6. Imaging or histological evidence supporting chronic structural kidney damage

Relevant CPT codes that may be used to treat ICD code N18.4 include:

- 90935 (Hemodialysis procedure with single physician evaluation)

- 90937 (Hemodialysis procedure requiring repeated physician evaluation)

- 90945 (Dialysis procedure other than hemodialysis, with single physician evaluation)

- 90947 (Dialysis procedure other than hemodialysis, requiring repeated physician evaluation)

- 90960 (End-stage renal disease related services, per month, for patients 20 years or older, with 4 or more visits per month)

- 90961 (End-stage renal disease related services, per month, for patients 20 years or older, with 2-3 visits per month)

- 99201–99215 (Evaluation and management services, as appropriate for office or outpatient visits)

- 36591 (Collection of blood specimen from a completely implantable venous access device)

- 36592 (Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified)

CPT code selection should be based on the specific services rendered and clinical scenario.

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