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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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The overall unadjusted percentage of US Military Health System (MHS) patients with a CKD code (ICD-9-CM, including end-stage renal disease [ESRD]) has been relatively stable at 2.8%–2.9% since 2009.

Stratified by sex, the unadjusted percentage of US Military Health System (MHS) patients with a CKD code (ICD-9-CM, including end-stage renal disease [ESRD]) has been relatively stable at 2.3%–2.4% for males and 3.3%–3.5% for females.

Stratified by race, the unadjusted percentage of US Military Health System (MHS) patients with a CKD code (ICD-9-CM, including end-stage renal disease [ESRD]) has been relatively stable at 1.7%–1.8% for White, 3.0%–3.2% for Black, 1.9%–2.1% for Asian/Pacific Islander, 1.4%–1.6% for Native American/Alaskan Native, 1.4%–2.0% for Other race, 6.7%–6.8% for Unknown race, and 3.7%–4.0% for Missing race.
Chart Explanation: 

These charts show the crude prevalence of CKD diagnosed by ICD-9-CM codes in the MHS by year of observation and CKD risk factor (age, sex, or race) status.

De-identified patient data were obtained from the MHS Data Repository (MDR).

CKD diagnosis was based on encounters with one or more of the matching ICD-9 codes. The full list of codes is provided in Field/Data. CKD diagnosis included ESRD, which was defined as having an ICD-9-M or Current Procedural Terminology (CPT) code for ESRD, chronic hemodialysis, chronic peritoneal dialysis, or kidney transplant.

For the calculation of CKD prevalence, the numerator was the number of patients with at least one inpatient or two outpatient CKD codes. The denominator was the number of patients with at least one inpatient or two outpatient encounters. Data cells with less than 11 patients were censored.

The views expressed are those of the authors and do not reflect the official policy of the Uniformed Services University, Departments of Army/Navy/Air Force, Department of Defense, Centers for Disease Control and Prevention, Department of Health and Human Services, or the US Government.

FieldData
Description of Measure

Percentage of Patients with an ICD-9-CM Code Indicating CKD or ESRD

Data SourceUS Department of Defense Military Health System (MHS) Data Repository (MDR)
Type of Data SourceAdministrative
Data SetMDR source files: CAPER (direct care outpatient claims), SIDR (direct care inpatient claims), TED-NI (purchased care outpatient claims), TED-I Header (purchased care inpatient claims), and VM6BEN (demographic information from the Defense Enrollment Eligibility Reporting System)
Health Care System DataYes
Regional or National?National
Demographic GroupPatients in MHS
Numerator

Patients in denominator with 1 inpatient or 2 outpatient encounters with matching ICD-9-CM codes for CKD or ESRD

Denominator

Patients with 1 inpatient or 2 outpatient encounters during the fiscal year

Definition of diagnosed CKD

See ICD-9-CM codes used for definition below

Primary Data Source IndicatorDiagnosis codes from outpatient or inpatient encounters
Primary Indicator Method of MeasurementMedical claims
Frequency of Measurement (Primary)Multiple measurements per patient
Period Currently Available2006–2015
Limitations of IndicatorICD-9 codes define CKD instead of serum creatinine
Analytical ConsiderationsIn published literature, CKD is diagnosed by ICD-9-CM codes in alternate ways (one outpatient, two or more outpatient, or one inpatient). In addition, there are differences in sampling methods. Care must be taken in making comparisons. These statistics include ESRD patients and use the one inpatient, two outpatient method of identifying CKD.
ICD-9 Codes for CKDSpecification
16Tuberculosis 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
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 pathological lesion 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
753.4Other specified anomalies of ureter
753.5Exstrophy of urinary bladder
753.6Atresia and stenosis of urethra and bladder neck
753.7Anomalies of urachus
753.8Other specified anomalies of bladder and urethra
753.9Unspecified anomaly of urinary system
791Proteinuria
791.1Chyluria
791.2Hemoglobinuria
791.3Myoglobinuria
791.4Biliuria
791.5Glycosuria
791.6Acetonuria
791.7Other cells and casts in urine
791.9Other nonspecific findings on examination of urine
794.4Nonspecific abnormal results of function study of kidney
585.6End stage renal disease
996.81Complications of kidney transplant
V42.0Kidney transplant status
V45.1Renal dialysis status
V56.0Renal dialysis encounter
V56.1Fitting/adjustment extracorporeal dialysis catheter
V56.2Fitting/adjustment peritoneal dialysis catheter
V56.3Encounter for adequacy testing for dialysis
V56.31Hemodialysis testing
V56.32Peritoneal dialysis test
V56.8Dialysis encounter, not elsewhere classified
E879.1Abnormal reaction-renal dialysis

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