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  Veterans Administration (VA) patients with any ICD-9-CM or ICD-10-CM diagnosis codes indicating the presence of CKD has risen over the years from 4.4% in 2005 to 17.1% in 2017 for age group 60 to 69.
Chart Explanation: These charts show the increasing prevalence of CKD diagnosed by ICD-9-CM codes in the VA health care system by age and year of observation, ICD-9-DM code or CKD risk factor (gender, race, diabetes, or hypertension) status.
National VA data were examined for veterans with at least one outpatient visit during the federal fiscal year. To estimate prevalence of CKD, outpatient 
serum creatinine laboratory results (averaged if a patient had more than one test during the fiscal year) were used to calculate an estimated glomerular 
filtration rate (eGFR) for each patient using the CKD-EPI equation, excluding dialysis and transplant patients. Estimated GFR (kidney function) was 
classified into five CKD categories (eGFR =90, eGFR 60-89, stage 3=eGFR 30-59, stage 4=eGFR 15 to 29, and stage 5 without dialysis=eGFR<15 ml/min/1.73 m² 
and “eGFR Unmeasured” for those patients without serum creatinine testing. Inpatient serum creatinine data were not used as they would be 
affected by the presence of acute illnesses. Due to the infrequency of testing, albuminuria was not included in the definition of CKD. Dialysis patients 
were defined by clinic stop-codes (602-611), outpatient procedure codes for dialysis (CPT4: 90921 and 90925), outpatient diagnosis codes (ICD-9-CM: 585.6, 
V56, V45.1 and E87.91) and inpatient and outpatient diagnosis codes (ICD-9-CM: 5856) to indicate dialysis. Kidney transplant patients were identified by
inpatient and outpatient ICD-9-CM diagnosis code V420 and inpatient procedure and surgery codes (55.69).

The VA data presented are from a national sample of health care visits to the VA Health System by eligible U. S. veterans. During any given year, ~ 70% of the outpatient population receives a serum creatinine test. While the demographics of VA Health System users are distinct from the general U.S. population, the VA data allow a ‘snapshot’ of clinical practices across the nation.

This material is the result of work supported with resources and the use of facilities at the VA Ann Arbor Health Care System, Ann Arbor, Michigan.
FieldData
Description of MeasurePrevalence of clinically diagnosed CKD (by ICD-9-CM) codes
Data SourceVA
Type of Data SourceAdministrative
Data SetVA National Data, using the MedSAS data files
Health Care System DataYes
Regional or National?National
Demographic GroupPatients in VA health system
NumeratorPatients in denominator with diagnosed CKD (ICD-9-CM codes) during outpatient or inpatient visit
DenominatorPatients >20 years old and who had 1+ outpatient visit in the fiscal year, within each specified age group
Definition of diagnosed CKDSee ICD-9-CM codes used for definition, below.
Primary Data Source IndicatorDiagnosis code from outpatient or inpatient visit
Primary Indicator Method of MeasurementMedical claim
Secondary (1) VariableAge = (Date of Visit - Date of Birth)/365.25
Frequency of Measurement (Primary)Multiple measurements per patient
Period Currently Available2005–2017
Limitations of IndicatorCKD as determined by serum creatinine lab and eGFR does not always generate an ICD-9-CM code.
Analytical ConsiderationsIn published literature, disease is diagnosed by ICD-9-CM codes in alternate ways (one outpatient; two or more outpatient or one inpatient; differences in sample). Care must be taken in comparisons.
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 renal failure
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
Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd