End stage renal disease

This code signifies the most severe form of chronic kidney disease (CKD), where kidney function has deteriorated to the point of requiring renal replacement therapy (dialysis or transplant) to sustain life. It indicates irreversible kidney failure with a glomerular filtration rate (GFR) typically below 15 mL/min/1.73 m².

Apply this code when a patient has documented end-stage renal disease, regardless of whether they are currently undergoing dialysis or have received a kidney transplant. Documentation should explicitly state "end-stage renal disease," "ESRD," or indicate a GFR consistent with stage 5 CKD requiring renal replacement.

• Always sequence this code as a primary diagnosis when it is the reason for the encounter, such as for dialysis services.
• Do not code N18.5 (Chronic kidney disease, stage 5) concurrently with this code; this code encompasses stage 5.
• Ensure documentation specifies the type of dialysis (e.g., hemodialysis, peritoneal dialysis) if applicable, as separate Z codes may be required.