Indicator Details: Percentage of Patients with an ICD-9-CM or ICD-10-CM Code Indicating CKD
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The overall percentage of patients with a CKD code (ICD-9-CM or ICD-10-CM diagnosis code, excluding ESRD) increased during the past decade.
Chart Explanation: These charts show the increasing prevalence of CKD diagnosed by ICD-9-CM or ICD-10-CM codes in the Centers for Medicare & Medicaid Services (CMS) Medicare data by age and year of observation, by ICD-9-CM or ICD-10-CM code or CKD risk factor (gender, race, diabetes, or hypertension) status.
Data are from the Medicare 5% Sample Limited Data Sets (LDS) for Inpatient, Outpatient, and Carrier (formerly known as Physician/Supplier Part B file) claims. For this indicator, patients identified as having end-stage renal disease (through the ESRD indicator provided in the “denominator” file) are not counted as having CKD diagnosis. See below for the list of ICD-9-CM or ICD-10-CM used to determine CKD.

Diagnoses for medical conditions within Medicare data come from claims submitted by providers for the fee-for-service sections of Medicare, Part A (hospital care) and Part B (ambulatory care). We restricted our analysis sample to beneficiaries aged 65 years or older who had Parts A and B coverage for the entire calendar year and have at least 1 outpatient visit in the calendar year. Between 20% and 25% of beneficiaries each year used Part C, managed care/Medicare Advantage plans, and are excluded because their care was paid on a capitated basis and claims with diagnoses are not available.
FieldData
Limitations of IndicatorAs a measure of prevalence, the use of ICD-9-CM or ICD-10-CM diagnosis codes will underestimate the level of chronic kidney disease in the general population.
Analytical ConsiderationsIn 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; differences in sample). Care must be taken in comparisons.
Secondary (2) VariableHypertension status 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) for hypertension on at least one inpatient, outpatient or carrier claim during the given calendar year.
Primary Indicator Method of MeasurementMedical claim
Secondary (1) VariableAge at the end of the previous calendar year
Description of MeasurePrevalence of clinically diagnosed CKD (by ICD-9-CM or ICD-10-CM codes)
Data SourceCenters for Medicare and Medicaid Services
Type of Data SourceAdministrative
Data SetMedicare National 5% Sample
Health Care System DataYes
Regional or National?National
Demographic GroupPatients aged 65 and older using fee-for-service Medicare
NumeratorPatients in denominator with diagnosed CKD from an outpatient, inpatient or carrier claim by any of the ICD-9-CM or ICD-10-CM CKD codes listed below.
Primary Data Source IndicatorDiagnosis codes from inpatient, outpatient and carrier claims
Period Currently Available2018
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

ICD-9-CM Codes for CKDSpecification
16Tuberculosis of kidney of kidney
95.4Syphilis of kidney
189Malignant neoplasm of kidney except pelvis
189.1Malignant neoplasm of renal pelvis
189.9Malignant neoplasm of urinary organ site unspecified
236.91Neoplasm of uncertain behavior of kidney and ureter
250.4Diabetes mellitus with renal manifestations type II or unspecified type not stated as uncontrolled
250.41Diabetes mellitus with renal manifestations type I not stated as uncontrolled
250.42Diabetes mellitus with renal manifestations type II or unspecified type uncontrolled
250.43Diabetes mellitus with renal manifestations type I uncontrolled
271.4Renal glycosuria
274.1Gouty nephropathy
283.11Hemolytic-uremic syndrome
403Malignant hypertensive renal disease without renal failure
403.01Malignant hypertensive renal disease with renal failure
403.1Benign hypertensive renal disease without renal failure
403.11Benign hypertensive renal disease with renal failure
403.9Unspecified hypertensive renal disease without renal failure
403.91Unspecified hypertensive renal disease with renal failure
404Malignant hypertensive heart and renal disease without heart failure or renal failure
404.01Malignant hypertensive heart and renal disease with heart failure
404.02Malignant hypertensive heart and renal disease with renal failure
404.03Malignant hypertensive heart and renal disease with heart failure and renal failure
404.1Benign hypertensive heart and renal disease without heart failure or renal failure
404.11Benign hypertensive heart and renal disease with heart failure
404.12Benign hypertensive heart and renal disease with renal failure
404.13Benign hypertensive heart and renal disease with heart failure and renal failure
404.9Unspecified hypertensive heart and renal disease without heart failure or renal failure
404.91Unspecified hypertensive heart and renal disease with heart failure
404.92Unspecified hypertensive heart and renal disease with renal failure
404.93Unspecified hypertensive heart and renal disease with heart failure and renal failure
405.01Malignant renovascular hypertension
440.1Atherosclerosis of renal artery
442.1Aneurysm of renal artery
447.3Hyperplasia of renal artery
453.3Embolism and thrombosis of renal vein
572.4Hepatorenal syndrome
580Acute glomerulonephritis with lesion of proliferative glomerulonephritis
580.4Acute glomerulonephritis with lesion of rapidly progressive; glomerulonephritis
580.81Acute glomerulonephritis in diseases classified elsewhere
580.89Acute glomerulonephritis with other specified pathologicallesion in kidney
580.9Acute glomerulonephritis with unspecified pathological lesion in kidney
581Nephrotic syndrome with lesion of proliferative glomerulonephritis
581.1Nephrotic syndrome with lesion of membranous glomerulonephritis
581.2Nephrotic syndrome with lesion of membranoproliferative glomerulonephritis
581.3Nephrotic syndrome with lesion of minimal change glomerulonephritis
581.81Nephrotic syndrome in diseases classified elsewhere
581.89Other nephrotic syndrome with specified pathological lesion in kidney
581.9Nephrotic syndrome with unspecified pathological lesion in kidney
582Chronic glomerulonephritis with lesion of proliferative glomerulonephritis
582.1Chronic glomerulonephritis with lesion of membranous glomerulonephritis
582.2Chronic glomerulonephritis with lesion of membranoproliferative glomerulonephritis
582.4Chronic glomerulonephritis with lesion of rapidly progressive glomerulonephritis
582.81Chronic glomerulonephritis in diseases classified elsewhere
582.89Other chronic glomerulonephritis with specified pathological lesion in kidney
582.9Chronic glomerulonephritis with unspecified pathological lesion in kidney
583Nephritis and nephropathy not specified as acute or chronic with lesion of proliferative glomerulonephritis
583.1Nephritis and nephropathy not specified as acute or chronic with lesion of membranous glomerulonephritis
583.2Nephritis and nephropathy not specified as acute or chronic with lesion of membranoproliferative glomerulonephritis
583.4Nephritis and nephropathy not specified as acute or chronic with lesion of rapidly progressive glomerulonephritis
583.6Nephritis and nephropathy not specified as acute or chronic with lesion of renal cortical necrosis
583.7Nephritis and nephropathy not specified as acute or chronic with lesion of renal medullary necrosis
583.81Nephritis and nephropathy not specified as acute or chronic in diseases classified elsewhere
583.89Other nephritis and nephropathy not specified as acute or chronic with specified pathological lesion in kidney
583.9Nephritis and nephropathy not specified as acute or chronic with unspecified pathological lesion in kidney
584.5Acute renal failure with lesion of tubular necrosis
584.6Acute renal failure with lesion of renal cortical necrosis
584.7Acute renal failure with lesion of renal medullary (papillary) necrosis
584.8Acute renal failure with other specified pathological lesion in kidney
584.9Acute renal failure unspecified
585.xChronic Kidney Disease (CKD)
      585.1 Stage 1     585.2 Stage 2     585.3 Stage 3     585.4 Stage 4
      585.5 Stage 5 (excluding dialysis)  585.6 End Stage Renal Disease
      585.9 Chronic kidney disease, unspecified
586Renal failure unspecified
587Renal sclerosis unspecified
588Renal osteodystrophy
588.1Nephrogenic diabetes insipidus
588.81Secondary hyperparathyroidism (of renal origin)
588.89Other specified disorders resulting from impaired renal function
588.9Unspecified disorder resulting from impaired renal function
589Small kidney of unknown cause
590Chronic pyelonephritis
590.8Other pyelonephritis or pyonephrosis not specified as acute or chronic
591Hydronephrosis
593.1Hypertrophy of kidney
593.3Stricture or kinking of ureter
593.4Other ureteric obstruction
593.5Hydroureter
593.6Postural proteinuria
593.7Vesicoureteral reflux
593.81Pyelitis or pyelonephritis in diseases classified elsewhere
593.89Other specified disorders of kidney and ureter
593.9Unspecified disorder of kidney and ureter
642.1Hypertension secondary to renal disease complicating pregnancy childbirth and the puerperium
646.2Unspecified renal disease in pregnancy without mention of hypertension
753Renal agenesis and dysgenesis
753.1Cystic kidney disease unspecified
753.11Congenital single renal cyst
753.12Polycystic kidney unspecified type
753.13Polycystic kidney autosomal dominant
753.14Polycystic kidney autosomal recessive
753.15Renal dysplasia
753.16Medullary cystic kidney
753.17,Medullary sponge kidney
753.19Other specified cystic kidney disease
753.2Unspecified obstructive defect of renal pelvis and ureter
753.21Congenital obstruction of ureteropelvic junction
753.22Congenital obstruction of ureterovesical junction
753.23Congenital ureterocele
753.29Other obstructive defect of renal pelvis and ureter
753.3Other specified anomalies of kidney
794.4Nonspecific abnormal results of function study of kidney
DenominatorPatients aged 65 or older with full-year Part A and B enrollment and at least one outpatient visit in the calendar year, within the specified age and hypertension status group.
Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd