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Trends in Serum Creatinine Testing among Commercially Insured Patients with Diagnosed CKD

Trends in Serum Creatinine Testing among Commercially Insured Patients with Diagnosed CKD

The prevalence of patients with diagnosed CKD receiving serum creatinine testing was 57.0% in 2007 and 77.5% in 2020, in a commercially insured patient population. Serum creatinine testing tended to be higher among older patients. The prevalence of patients younger than 60 years receiving serum creatinine testing decreased from 2007 to 2020. Hispanic patients tended to have the lowest prevalence of testing. The prevalence of serum creatinine testing tended to be higher for patients with diabetes than without diabetes. Patients with hypertension were approximately 1.5 times as likely to receive serum creatinine testing than those without hypertension across this time period.

Data Source: Clinformatics Commercial

To view serum creatinine testing by risk categories, select from the drop-down menu below. Risk categories include: Overall, Age Category, Sex, Race/Ethnicity, CKD Stage, Diabetes, and Hypertension.


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Data includes diagnosed CKD stages 1–5. Data are not adjusted.

Clinformatics data sets provide paid medical and prescription claims and enrollment information for participants in commercial insurance plans and Medicare Advantage plans. The sample was limited to those enrolled in their health plan for all 12 months of the calendar year. Chronic kidney disease (CKD) and diabetes are defined using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), or Tenth Revision (ICD-10-CM) diagnosis codes. Outpatient pharmacy records of prescriptions filled for patients were examined for drugs in the sodium-glucose cotransporter-2 (SGLT2) inhibitors class. For inclusion in analyses, beneficiaries had to be in the enrollment file. To define CKD, diabetes, or hypertension, at least one inpatient or two outpatient claims were used.

Description of Measure

Serum creatinine testing rates of patients with CKD diagnosis in the prior calendar year in the Clinformatics Commercial population.

Data Set

Clinformatics Commercial from Optum Clinformatics Data Mart Database (Optum Insight, Eden Prairie, MN).


Privately insured patients aged ≥ 20 years with at least one inpatient or two outpatient claims during the calendar year.

Years Included



Patients aged ≥ 20 years with serum creatinine testing claims within the specified calendar year.


Patients aged ≥ 20 years enrolled in Clinformatics Commercial insurance and diagnosed with CKD.

Definition of CKD

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

ICD-10-CM Codes for CKD

Stages 1–2: N17.1, N17.2

Stages 3–5: N17.3, N17.4, N17.5

Any 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, , 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

Stages 1–2: 585.1, 585.2

Stages 3–5: 585.3, 585.4, 585.5

Any 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.

Serum Creatinine Testing

Serum creatinine test is identified by CPT codes (82565, 80047, 80048, 80053, 80069, 82610, and 80050).

Limitations of Indicator

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

Analytical Considerations

Consideration must be taken in comparisons based on diagnosis code-based definitions of CKD.