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Kidney Disease Surveillance System

 
Home > Prevalence & Incidence > Prevalence of CKD in the Healthcare System > Prevalence of Diagnosed CKD among Medicare Beneficiaries aged ≥ 65 Years, by U.S. State and County

Prevalence of Diagnosed CKD among Medicare Beneficiaries aged ≥ 65 Years, by U.S. State and County

Prevalence of Diagnosed CKD among Medicare Beneficiaries aged ≥ 65 Years, by U.S. State and County

The distribution of diagnosed chronic kidney disease (CKD) among individuals aged 65 and older varies by US region. Areas with the highest prevalence of diagnosed CKD are in Southern California, Florida, the Appalachian region, and the Midwest. The Rocky Mountain region has the lowest prevalence of diagnosed CKD in this population. 

Data Source: CMS
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Estimates are based on data from over 1.8 million beneficiaries each year from the 5% Medicare random sample. Data are not adjusted.

CMS maintains claims data on beneficiaries aged 65 years and older, those with disabilities, and those with end-stage kidney disease. A 5% random sample of beneficiaries who had at least one inpatient or outpatient visit during the calendar year—over 1.8 million annually—of Medicare claims data was used.

Diagnoses for medical conditions in Medicare data come from claims submitted by providers for Medicare fee-for-service Part A (hospital insurance) and Part B (medical insurance). The analysis sample was limited to beneficiaries aged 65 years or older who had Parts A and B coverage for the entire calendar year and had at least one inpatient or outpatient visit in that calendar year. Between 20% and 37% of beneficiaries each year used Part C (managed care/Medicare Advantage plans) and are excluded because their care was paid on fixed amount and claims with diagnoses are unavailable. Chronic kidney disease, diabetes, and hypertension are defined by at least one diagnosis code for each condition.

FieldData
Description of Indicator

County and state estimates of diagnosed CKD among Medicare Beneficiaries aged ≥ 65 years.

Dataset

Medicare 5% random sample.

Population

Medicare fee-for-service beneficiaries aged ≥ 65 years.

Years Included

2019

Numerator

Medicare fee-for-service beneficiaries aged ≥ 65 years with diagnosed CKD from claims by any of the ICD-9-CM or ICD-10-CM CKD codes listed below.

Denominator

Medicare fee-for-service beneficiaries aged ≥ 65 years with full-year Parts A and B enrollment and at least one inpatient or outpatient visit in the given calendar year.

Definition of CKD

ICD-9-CM and ICD-10-CM diagnosis codes.

ICD-10-CM Codes for CKD

A18.11, A52.75, B52.0, C64.x, C68.9, D30.0x, D41.0x-D41.2x, D59.3, E08.2x, E09.2x, E10.2x, E10.65, E11.2x, E11.65, E13.2x, E74.8, I12.xx, I13.0, I13.1x, I13.2, K76.7, M10.3x, M32.14, M32.15, N01.x-N08.x, N13.1, N13.1x-N13.39, N14.x,N15.0, N15.8, N15.9, N16, N17.x, N18.1-N18.5, N18.8, N18.9, N19, N25.xx, N26.1, N26.9, O10.4xx, O12.xx, O26.83x, O90.89, Q61.02, Q61.1x-Q61.8, Q26.0-Q26.39, R94.4
(x and xx stand for all the codes within the main diagnosis).

ICD-9-CM Codes for CKD

016.0, 095.4, 189.0,189.1, 189.9, 236.91, 250.4, 250.41, 250.42, 250.43, 271.4, 274.10, 283.11, 403.xx, 404.xx, 405.01, 405.11, 440.1, 442.1, 447.3, 453.3, 573.4, 580.xx, 581.xx, 582.xx, 583.xx, 584.5, 585.x, 587.xx, 588.xx, 590.xx, 591, 592.x, 593.xx, 642.1, 646.2, 753.xx, 794.4.

Diabetes

Diabetes is determined by the presence of an ICD-9-CM code (250.xx, 357.2, 336.41, 362.01, 362.02) or ICD-10-CM (E08.xx, E09.xx, E10.xx, E11.xx, E13.xx) on at least one claim during the given calendar year.

Hypertension

Hypertension is determined by the presence of an ICD-9-CM code (401.x through 405.x) or ICD-10-CM code (H35.03x, I10.xx, I11.xx, I12.xx, I13.xx, I15.xxx, I67.4, N26.2) on at least one claim during the given calendar year.

Limitations of Indicator

As a measure of prevalence, the use of ICD-9-CM or ICD-10-CM diagnosis codes will likely underestimate CKD.

Analytical Considerations

Counties with 10 or fewer beneficiaries have been suppressed to protect potential identification of individuals.