Certified Risk Adjustment Coder (CRC)

Which physician assessment supports correct coding of CKD stage 2, code N18.2?

1. A/P: Mild CKD

2. Assessment and Plan: Moderate CKD

3. Assessment: Severe Chronic Kidney Disease

4. A/P: ESRD

The correct answer is: A/P: Mild CKD

The correct answer relates to the proper assessment of chronic kidney disease (CKD) in order to accurately assign the diagnosis code N18.2, which corresponds to stage 2 CKD. In this case, the assessment stating "Mild CKD" appropriately aligns with the definition of stage 2 CKD, which is characterized by a slight decline in kidney function (GFR between 60-89 mL/min) along with evidence of kidney damage. This assessment demonstrates understanding of the progression of the disease, categorizing it correctly in a manner consistent with the definitions set forth in coding guidelines. The other assessments do not accurately reflect stage 2 CKD. For instance, stating "Moderate CKD" could correspond more to stage 3 (GFR 30-59 mL/min), which would necessitate a different code. An assessment of "Severe Chronic Kidney Disease" is reflective of stage 4 (GFR 15-29 mL/min), while "ESRD" refers to end-stage renal disease (stage 5, GFR less than 15 mL/min), which also requires a different coding approach. Thus, only the assessment of "Mild CKD" rightly supports the coding for stage