CDC Surveillance System: Percentage of Patients with ICD-9-CM or ICD-10-CM Codes Indicating CKD or ESRD

Prevalence and Incidence

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Prevalence of CKD in the General Population

Prevalence of CKD in the Health Care System Population

Incidence of CKD in the Health Care System Population

Prevalence of CKD Towards Tracking Healthy People 2030 Goals

Awareness

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Person Awareness of CKD

Provider Awareness of CKD

CKD with ICD-9-CM Codes Among U.S. Veterans with CKD Stages 3-5

CKD Awareness Towards Tracking HP2020 Goals

Increase the Proportion of Adults with Chronic Kidney Disease Who Know They Have It

Burden of Risk Factors

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Diabetes in the General Population

Diabetes in the Health Care System Population

U.S. Adults with a Diagnosis of Diabetes

Hypertension in the General Population

Hypertension in the Health Care System Population

U.S. Adults with a Diagnosis of Hypertension

Obesity in the General Population

CVD in the General Population

Smoking in the General Population

Age in the Health Care System Population

Age of U.S. Adults

Race/Ethnicity in the Health Care System Population

U.S. Adults by Race/Ethnicity

Food Insecurity in CKD

Health Consequences

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Mortality in CKD in the Health Care System Population

Mortality Rates by eGFR Category/stage

Physical and Mental Functioning in CKD

Risk Factors for Progression of CKD

Progression

One-year Progression of CKD in U.S. Veterans

Risk Factors for CKD Complications Towards Tracking HP2020 Goals

Quality of Care

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Laboratory Testing for CKD in the Health Care System

Nephrology Care Prior to ESRD

Use of Medications in CKD

Blood Pressure Treatment and Control in CKD

Trends in Hypertension Diagnosis, Treatment, and Control Among Us Veterans

Health Care System Capacity

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Indicator Details: Percentage of Patients with ICD-9-CM or ICD-10-CM Codes Indicating CKD or ESRD

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CMS-Medicare
Clinformatics Commercial
Clinformatics Medicare Advantage
CMS-Medicaid

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Percentage of Patients with ICD-9-CM or ICD-10-CM Codes Indicating CKD or ESRD by Code and Diabetes and Year Clinformatics Medicare Advantage
Diabetes	Year	No CKD Code	Any CKD code	ESRD
With Diabetes	2006	92.9% (CI 92.7-93.2)	6.9% (CI 6.7-7.2)	.2% (CI .1-.2)
With Diabetes	2007	91.9% (CI 91.7-92.2)	7.8% (CI 7.6-8.0)	.2% (CI .2-.3)
With Diabetes	2008	89.7% (CI 89.5-89.9)	10.1% (CI 9.9-10.3)	.2% (CI .2-.3)
With Diabetes	2009	86.1% (CI 85.9-86.2)	13.7% (CI 13.5-13.8)	.3% (CI .2-.3)
With Diabetes	2010	84.3% (CI 84.1-84.4)	15.5% (CI 15.3-15.6)	.3% (CI .3-.3)
With Diabetes	2011	82.3% (CI 82.1-82.4)	17.4% (CI 17.3-17.6)	.3% (CI .3-.3)
With Diabetes	2012	81.4% (CI 81.3-81.6)	18.2% (CI 18.1-18.3)	.4% (CI .3-.4)
With Diabetes	2013	80.0% (CI 79.9-80.1)	19.6% (CI 19.5-19.7)	.4% (CI .4-.4)
With Diabetes	2014	78.0% (CI 77.9-78.1)	21.5% (CI 21.4-21.6)	.5% (CI .5-.5)
With Diabetes	2015	75.4% (CI 75.3-75.6)	24.0% (CI 23.8-24.1)	.6% (CI .6-.6)
With Diabetes	2016	72.4% (CI 72.3-72.5)	26.9% (CI 26.8-27.0)	.7% (CI .7-.7)
With Diabetes	2017	70.3% (CI 70.2-70.4)	28.9% (CI 28.8-29.0)	.8% (CI .8-.9)
With Diabetes	2018	68.1% (CI 68.0-68.2)	30.9% (CI 30.8-31.0)	1.0% (CI 1.0-1.1)
With Diabetes	2019	65.7% (CI 65.6-65.8)	33.1% (CI 33.0-33.2)	1.2% (CI 1.2-1.3)
With Diabetes	2020	64.8% (CI 64.7-64.8)	33.8% (CI 33.7-33.8)	1.5% (CI 1.4-1.5)
Without Diabetes	2006	99.0% (CI 99.0-99.0)	1.0% (CI .9-1.0)	.0% (CI .0-.0)
Without Diabetes	2007	98.8% (CI 98.7-98.8)	1.2% (CI 1.2-1.2)	.0% (CI .0-.0)
Without Diabetes	2008	97.7% (CI 97.7-97.8)	2.2% (CI 2.2-2.2)	.0% (CI .0-.1)
Without Diabetes	2009	96.4% (CI 96.4-96.5)	3.5% (CI 3.5-3.6)	.1% (CI .0-.1)
Without Diabetes	2010	95.7% (CI 95.7-95.7)	4.2% (CI 4.2-4.3)	.1% (CI .1-.1)
Without Diabetes	2011	95.1% (CI 95.0-95.1)	4.9% (CI 4.8-4.9)	.1% (CI .1-.1)
Without Diabetes	2012	94.8% (CI 94.8-94.9)	5.1% (CI 5.0-5.1)	.1% (CI .1-.1)
Without Diabetes	2013	94.4% (CI 94.4-94.5)	5.5% (CI 5.5-5.5)	.1% (CI .1-.1)
Without Diabetes	2014	94.1% (CI 94.0-94.1)	5.9% (CI 5.8-5.9)	.1% (CI .1-.1)
Without Diabetes	2015	93.3% (CI 93.2-93.3)	6.6% (CI 6.6-6.7)	.1% (CI .1-.1)
Without Diabetes	2016	92.3% (CI 92.2-92.3)	7.6% (CI 7.6-7.7)	.1% (CI .1-.1)
Without Diabetes	2017	91.2% (CI 91.2-91.3)	8.7% (CI 8.6-8.7)	.1% (CI .1-.1)
Without Diabetes	2018	90.3% (CI 90.3-90.4)	9.5% (CI 9.5-9.6)	.1% (CI .1-.1)
Without Diabetes	2019	89.2% (CI 89.2-89.2)	10.6% (CI 10.6-10.7)	.2% (CI .2-.2)
Without Diabetes	2020	89.7% (CI 89.7-89.7)	10.1% (CI 10.1-10.2)	.2% (CI .2-.2)
Diabetes	2006	89.9% (CI 8.8-8.9)	9.5% (CI .9-1.0)	.5% (CI .0-.1)
Diabetes	2007	88.2% (CI 10.9-11.0)	11.2% (CI 1.4-1.4)	.6% (CI .1-.1)
Diabetes	2008	85.2% (CI 14.7-14.8)	14.1% (CI 2.4-2.5)	.7% (CI .1-.1)
Diabetes	2009	81.0% (CI 16.0-16.1)	18.2% (CI 3.6-3.6)	.8% (CI .2-.2)
Diabetes	2010	78.9% (CI 15.7-15.8)	20.2% (CI 4.0-4.1)	.9% (CI .2-.2)
Diabetes	2011	76.6% (CI 16.1-16.2)	22.5% (CI 4.7-4.8)	1.0% (CI .2-.2)
Diabetes	2012	75.8% (CI 16.6-16.6)	23.2% (CI 5.0-5.1)	1.1% (CI .2-.2)
Diabetes	2013	74.3% (CI 16.8-16.9)	24.5% (CI 5.5-5.6)	1.1% (CI .3-.3)
Diabetes	2014	72.4% (CI 16.4-16.5)	26.3% (CI 5.9-6.0)	1.3% (CI .3-.3)
Diabetes	2015	70.2% (CI 16.2-16.3)	28.5% (CI 6.6-6.6)	1.4% (CI .3-.3)
Diabetes	2016	67.7% (CI 16.4-16.5)	30.7% (CI 7.4-7.5)	1.6% (CI .4-.4)
No Diabetes	2006	98.6% (CI 88.8-89.0)	1.3% (CI 1.1-1.2)	.1% (CI .0-.1)
No Diabetes	2007	98.1% (CI 85.8-86.0)	1.9% (CI 1.6-1.6)	.1% (CI .1-.1)
No Diabetes	2008	96.6% (CI 79.8-80.0)	3.3% (CI 2.7-2.7)	.1% (CI .1-.1)
No Diabetes	2009	94.9% (CI 76.1-76.2)	4.9% (CI 3.9-4.0)	.1% (CI .1-.1)
No Diabetes	2010	94.2% (CI 75.3-75.5)	5.7% (CI 4.5-4.6)	.1% (CI .1-.1)
No Diabetes	2011	93.2% (CI 73.5-73.7)	6.6% (CI 5.2-5.3)	.2% (CI .1-.1)
No Diabetes	2012	92.7% (CI 72.4-72.5)	7.1% (CI 5.5-5.6)	.2% (CI .1-.1)
No Diabetes	2013	92.1% (CI 71.2-71.3)	7.8% (CI 6.0-6.0)	.2% (CI .1-.2)
No Diabetes	2014	91.6% (CI 70.8-70.9)	8.2% (CI 6.3-6.4)	.2% (CI .2-.2)
No Diabetes	2015	90.7% (CI 69.6-69.7)	9.1% (CI 7.0-7.0)	.2% (CI .2-.2)
No Diabetes	2016	90.0% (CI 68.1-68.2)	9.8% (CI 7.4-7.4)	.2% (CI .2-.2)

Notes:

* Indicates that the result for this cell was suppressed because of imprecision due to a sample size that was too small or the standard error of the result being too large (>30% of the estimate).
95% confidence intervals, when available, are shown in parentheses.

The overall unadjusted percentage of patients with a CKD code (ICD-9-CM or ICD-10-CM diagnosis code, excluding ESRD) has slightly increased in the last decade, for patients aged 65 years or older enrolled in Clinformatics Medicare Advantage insurance.

Chart Explanation: The prevalence of diagnosed CKD increases only minimally in each of the years studied. The y-axis (vertical line) shows the percentage of CKD, and the x-axis (horizontal line) shows the CKD groups (No CKD or ESRD, CKD but not ESRD, ESRD).

The Clinformatics™ Medicare Advantage from OPTUM Clinformatics Data Mart provides paid medical and prescription claims and enrollment information for participants in Medicare Advantage plans.

CKD is defined using ICD-9-CM or ICD-10-CM diagnosis codes, and ESRD is based on International Classificiation of Diseases (ICD) diagnosis, Current Procedural Terminology (CPT) procedure, and DiagnosIs Related Group (DRG) codes in the Clinformatics Medicare Advantage.

Field	Data
Description of Measure	Prevalence of clinically diagnosed CKD (by ICD-9-CM or ICD-10-CM codes) and ESRD stratified by age, race/ethnicity, gender, diabetes diagnosis and hypertension diagnosis.
Data Source	Clinformatics Medicare Advantage from Clinformatics™ Data Mart Database (OptumInsight, Eden Prairie, MN)
Type of Data Source	Administrative
Data Set	Clinformatics Medicare Advantage enrollees age 65 years or older.
Health Care System Data	Yes.
Regional or National	Regional.
Demographic Group	Patients age 65 years or older enrolled in Clinformatics Medicare Advantage insurance.
Numerator	Patients in denominator with diagnosed CKD from one inpatient or two outpatient claims by any of the ICD-9-CM or ICD-10-CM CKD codes listed below or identified as having ESRD.
Denominator	Patients age 65 years or older with full year of enrollment in a given calendar year.
Primary Data Source Indicator	Diagnosis code from inpatient and outpatient files.
Primary Indicator Method of Measurement	Medical claim.
Secondary (1) Variable	Age in years at the end of the current calendar year.
Secondary (2) Variable	Race/ethnicity
Secondary (3) Variable	Sex/Gender
Secondary (4) Variable	Diabetes status determined by the presence of an ICD-9-CM or ICD-10-CM code for diabetes, or diabetic complications, on at least one inpatient, outpatient or medical services claim during a given calendar year.
Secondary (5) Variable	Hypertension status determined by the presence of an ICD-9-CM or ICD-10-CM code for hypertension on at least one inpatient, outpatient or medical services claim during a given calendar year.
Period Currently Available	2016
Limitations of Indicator	The use of ICD-9-CM or ICD-10-CM diagnosis code as measure of prevalence, will underestimate the level of chronic kidney disease in the general population.
Analytical Considerations	In published literature, disease is diagnosed by ICD-9-CM or ICD-10-CM codes in alternate ways (one outpatient, two or more outpatient or one inpatient. Care must be taken in comparisons.
ICD-9-CM Codes for CKD	016.0; 095.4; 189.0,189.9; 223.0; 236.91; 250.4; 271.4; 274.1; 283.11; 403; 404; 440.1; 442.1; 477.3; 572.4; 581-588; 591; 642.1; 646.2; 753.12-753.19; 753.2; 794.4
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

Suggested Citation:

Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd