Indicator Details: Percentage of Patients with CKD with ICD-9-CM or ICD-10-CM Codes for CKD
Data Sources
 
Stratification and Year Choices:

  Source
  • NATIONAL VA

  Chart Format


+ View Data Table




Overall, for VA patients with evidence of CKD stages 3-5 based on available outpatient serum creatinine values, the percentage who also had an ICD-9-CM or ICD-10-CM diagnosis code for CKD increased over time from 19% in 2005 to 45% in 2018.
Chart Explanation: The chart shows on the y-axis (vertical line) the percentage of patients with CKD with ICD-9-DM or ICD-10-DM codes for CKD and on the x-axis (horizontal line) distribution by gender, diabetes, hypertension, and CKD stage by year, age, and nephrology visit.
The Veteran’s Affairs (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.

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 ICD-10-CM: N186, Y841, Z4931, Z4901, Z4902, Z4931, Z4932, and Z4933)  to indicate dialysis. Kidney transplant patients were identified by inpatient and outpatient ICD-9-CM diagnosis code V420, 99681, or ICD-10 CM diagnosis code T86X, Z4822 and Z940, and inpatient procedure and surgery codes (55.69).

This material is the result of work supported with resources and the use of facilities at the Veterans Affairs Ann Arbor Health Care System, Ann Arbor, Michigan.
FieldData
Additional Data Items of InterestOther stratification variables of interest (diabetes, hypertension)
Period Currently Available2018
Secondary (2) Indicator Method of MeasurementOutpatient visit
Frequency of Measurement (Primary)Multiple measurements per patient
Secondary (1) Variable : CKD by eGFRStage 3 (eGFR 30-<60); Stage 4 (eGFR 15-<30); Stage 5 (eGFR <15 ); Stages 3-5 (eGFR <60); all measured in units of ml/min per 1.73 m²
Glomerular filtration rateEstimated using the CKD-EPI equation: eGFR=141 X min(SCR/K,1)**A X max(SCR/K,1)**-1.209 X 0.993**Age X 1.018[if female] X 1.159[if black] where SCR is serum creatinine in mg/dl, min is the minimum of SCR/K or 1, max is the maximum of SCR/K or 1, K=0.7 for female or K=0.9 for male, A is -.329 for female and -.411 for male. Missing race/ethnicity was coded as white. ** signifies "raised to the power of".
Secondary (1) Data Source IndicatorSerum Creatinine Lab Result Value
Secondary (1) Indicator Method of MeasurementLaboratory: A valid serum creatinine value was defined as 0.3-15.0 mg/dl. Any values outside of this range were set to “missing.” No more than 1% of serum creatinine values in each cohort were outside of this range.
Secondary (2) VariableNephrology or non-nephrology clinic
Secondary (2) Indicator Method of MeasurementClinic Stop Code
Description of MeasurePrevalence of ICD-9-CM or ICD-10-CM code diagnosed CKD among those with eGFR<60
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 system
NumeratorPatients in denominator with at least 1 ICD-9-CM or ICD-10-CM code for CKD during outpatient or inpatient visit
DenominatorPatients >20 years old and who had CKD Stages 3-5 by eGFR from an outpatient serum creatinine measure (excluding 5T and 5D)
Definition of diagnosed CKDSee ICD-9-CM cdes below. For ICD-10-CM codes, use the "contact us" link on the top right of the website. 
Primary Data Source IndicatorDiagnosis code from outpatient or inpatient visit
Primary Indicator Method of MeasurementMedical claim
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