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

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 an ICD-9-CM or ICD-10-CM Code Indicating CKD

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Percentage of Patients with an ICD-9-CM or ICD-10-CM Code Indicating CKD by Age and Race/Ethnicity For 2014 Centers for Medicare & Medicaid Services - Medicare
Race/Ethnicity	65–69 years	70–79 years	80–89 years	90+ years
Non-Hispanic White	12.2% (CI 12.0-12.3)	18.1% (CI 17.9-18.2)	26.2% (CI 26.0-26.4)	30.6% (CI 30.2-31.0)
Non-Hispanic Black	20.0% (CI 19.6-20.4)	27.1% (CI 26.7-27.6)	34.2% (CI 33.5-35.0)	38.8% (CI 37.2-40.3)
Hispanic	14.9% (CI 13.9-15.9)	20.1% (CI 19.1-21.2)	31.1% (CI 29.8-32.5)	31.4% (CI 28.6-34.3)
North American Native	15.6% (CI 13.9-17.3)	20.6% (CI 19.0-22.3)	28.5% (CI 25.7-31.4)	39.5% (CI 31.6-47.4)
Asian	12.9% (CI 12.1-13.8)	19.3% (CI 18.4-20.1)	29.5% (CI 28.2-30.7)	33.9% (CI 31.0-36.8)
Other	11.3% (CI 10.7-11.8)	18.5% (CI 17.7-19.3)	26.8% (CI 25.3-28.4)	34.6% (CI 30.5-38.7)

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.

Field	Data
Limitations of Indicator	As 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 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; differences in sample). Care must be taken in comparisons.
Secondary (2) Variable	Hypertension 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 Measurement	Medical claim
Secondary (1) Variable	Age at the end of the previous calendar year
Description of Measure	Prevalence of clinically diagnosed CKD (by ICD-9-CM or ICD-10-CM codes)
Data Source	Centers for Medicare and Medicaid Services
Type of Data Source	Administrative
Data Set	Medicare National 5% Sample
Health Care System Data	Yes
Regional or National?	National
Demographic Group	Patients aged 65 and older using fee-for-service Medicare
Numerator	Patients 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 Indicator	Diagnosis codes from inpatient, outpatient and carrier claims
Period Currently Available	2018
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 CKD	Specification
16	Tuberculosis of kidney of kidney
95.4	Syphilis of kidney
189	Malignant neoplasm of kidney except pelvis
189.1	Malignant neoplasm of renal pelvis
189.9	Malignant neoplasm of urinary organ site unspecified
236.91	Neoplasm of uncertain behavior of kidney and ureter
250.4	Diabetes mellitus with renal manifestations type II or unspecified type not stated as uncontrolled
250.41	Diabetes mellitus with renal manifestations type I not stated as uncontrolled
250.42	Diabetes mellitus with renal manifestations type II or unspecified type uncontrolled
250.43	Diabetes mellitus with renal manifestations type I uncontrolled
271.4	Renal glycosuria
274.1	Gouty nephropathy
283.11	Hemolytic-uremic syndrome
403	Malignant hypertensive renal disease without renal failure
403.01	Malignant hypertensive renal disease with renal failure
403.1	Benign hypertensive renal disease without renal failure
403.11	Benign hypertensive renal disease with renal failure
403.9	Unspecified hypertensive renal disease without renal failure
403.91	Unspecified hypertensive renal disease with renal failure
404	Malignant hypertensive heart and renal disease without heart failure or renal failure
404.01	Malignant hypertensive heart and renal disease with heart failure
404.02	Malignant hypertensive heart and renal disease with renal failure
404.03	Malignant hypertensive heart and renal disease with heart failure and renal failure
404.1	Benign hypertensive heart and renal disease without heart failure or renal failure
404.11	Benign hypertensive heart and renal disease with heart failure
404.12	Benign hypertensive heart and renal disease with renal failure
404.13	Benign hypertensive heart and renal disease with heart failure and renal failure
404.9	Unspecified hypertensive heart and renal disease without heart failure or renal failure
404.91	Unspecified hypertensive heart and renal disease with heart failure
404.92	Unspecified hypertensive heart and renal disease with renal failure
404.93	Unspecified hypertensive heart and renal disease with heart failure and renal failure
405.01	Malignant renovascular hypertension
440.1	Atherosclerosis of renal artery
442.1	Aneurysm of renal artery
447.3	Hyperplasia of renal artery
453.3	Embolism and thrombosis of renal vein
572.4	Hepatorenal syndrome
580	Acute glomerulonephritis with lesion of proliferative glomerulonephritis
580.4	Acute glomerulonephritis with lesion of rapidly progressive; glomerulonephritis
580.81	Acute glomerulonephritis in diseases classified elsewhere
580.89	Acute glomerulonephritis with other specified pathologicallesion in kidney
580.9	Acute glomerulonephritis with unspecified pathological lesion in kidney
581	Nephrotic syndrome with lesion of proliferative glomerulonephritis
581.1	Nephrotic syndrome with lesion of membranous glomerulonephritis
581.2	Nephrotic syndrome with lesion of membranoproliferative glomerulonephritis
581.3	Nephrotic syndrome with lesion of minimal change glomerulonephritis
581.81	Nephrotic syndrome in diseases classified elsewhere
581.89	Other nephrotic syndrome with specified pathological lesion in kidney
581.9	Nephrotic syndrome with unspecified pathological lesion in kidney
582	Chronic glomerulonephritis with lesion of proliferative glomerulonephritis
582.1	Chronic glomerulonephritis with lesion of membranous glomerulonephritis
582.2	Chronic glomerulonephritis with lesion of membranoproliferative glomerulonephritis
582.4	Chronic glomerulonephritis with lesion of rapidly progressive glomerulonephritis
582.81	Chronic glomerulonephritis in diseases classified elsewhere
582.89	Other chronic glomerulonephritis with specified pathological lesion in kidney
582.9	Chronic glomerulonephritis with unspecified pathological lesion in kidney
583	Nephritis and nephropathy not specified as acute or chronic with lesion of proliferative glomerulonephritis
583.1	Nephritis and nephropathy not specified as acute or chronic with lesion of membranous glomerulonephritis
583.2	Nephritis and nephropathy not specified as acute or chronic with lesion of membranoproliferative glomerulonephritis
583.4	Nephritis and nephropathy not specified as acute or chronic with lesion of rapidly progressive glomerulonephritis
583.6	Nephritis and nephropathy not specified as acute or chronic with lesion of renal cortical necrosis
583.7	Nephritis and nephropathy not specified as acute or chronic with lesion of renal medullary necrosis
583.81	Nephritis and nephropathy not specified as acute or chronic in diseases classified elsewhere
583.89	Other nephritis and nephropathy not specified as acute or chronic with specified pathological lesion in kidney
583.9	Nephritis and nephropathy not specified as acute or chronic with unspecified pathological lesion in kidney
584.5	Acute renal failure with lesion of tubular necrosis
584.6	Acute renal failure with lesion of renal cortical necrosis
584.7	Acute renal failure with lesion of renal medullary (papillary) necrosis
584.8	Acute renal failure with other specified pathological lesion in kidney
584.9	Acute renal failure unspecified
585.x	Chronic 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
586	Renal failure unspecified
587	Renal sclerosis unspecified
588	Renal osteodystrophy
588.1	Nephrogenic diabetes insipidus
588.81	Secondary hyperparathyroidism (of renal origin)
588.89	Other specified disorders resulting from impaired renal function
588.9	Unspecified disorder resulting from impaired renal function
589	Small kidney of unknown cause
590	Chronic pyelonephritis
590.8	Other pyelonephritis or pyonephrosis not specified as acute or chronic
591	Hydronephrosis
593.1	Hypertrophy of kidney
593.3	Stricture or kinking of ureter
593.4	Other ureteric obstruction
593.5	Hydroureter
593.6	Postural proteinuria
593.7	Vesicoureteral reflux
593.81	Pyelitis or pyelonephritis in diseases classified elsewhere
593.89	Other specified disorders of kidney and ureter
593.9	Unspecified disorder of kidney and ureter
642.1	Hypertension secondary to renal disease complicating pregnancy childbirth and the puerperium
646.2	Unspecified renal disease in pregnancy without mention of hypertension
753	Renal agenesis and dysgenesis
753.1	Cystic kidney disease unspecified
753.11	Congenital single renal cyst
753.12	Polycystic kidney unspecified type
753.13	Polycystic kidney autosomal dominant
753.14	Polycystic kidney autosomal recessive
753.15	Renal dysplasia
753.16	Medullary cystic kidney
753.17,	Medullary sponge kidney
753.19	Other specified cystic kidney disease
753.2	Unspecified obstructive defect of renal pelvis and ureter
753.21	Congenital obstruction of ureteropelvic junction
753.22	Congenital obstruction of ureterovesical junction
753.23	Congenital ureterocele
753.29	Other obstructive defect of renal pelvis and ureter
753.3	Other specified anomalies of kidney
794.4	Nonspecific abnormal results of function study of kidney
Denominator	Patients 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