Q&A: Reporting ATN after kidney transplant in ICD-10-CM

Q: Our coding team is currently debating how to report acute tubular necrosis (ATN) in ICD-10-CM for a patient after a renal transplant. Can you provide any guidance?

A: When the ATN is of the transplanted kidney then this would be coded as a complication of the transplant followed by the code for the type of acute kidney injury.

The complication code of kidney transplant failure would be reported as ICD-10-CM code T86.12 (kidney transplant failure) followed by N17.0 (acute kidney failure with tubular necrosis) to capture the ATN. Remember that whenever a complication code is required, always report your complication codes first and then list the specific condition as a secondary code in harmony with the ICD-10-CM Official Guidelines for Coding and Reporting and ICD-10-CM coding manual directions.

Editor’s note: Sarah Humbert, RHIA, AHIMA-certified ICD-10-CM/PCS trainer, coding and compliance manager at KIWI-TEK, LLC, and Temeka Davis, RHIT, coding manager at KIWI-TEK, LLC, answered this question during HCPro’s webinar Acute Kidney Injury and Acute Renal Failure: 2018 Coding, Criteria, and Classifications

This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.

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