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Exact Dx synthetic data · demonstration

← How it decides

Staff view only: ICD-10-CM ladder and combination-code linkage

Staff view only: the coding ladder. Never shown to the clinician.

Rule and version
kidney_staff@1.0
Published source
ICD-10-CM Official Guidelines for Coding and Reporting FY2026: I.A.15 ('with' convention), I.C.9.a.2 (hypertensive chronic kidney disease), I.C.4.a (diabetes with CKD, E11.22 plus N18.x). CC/MCC levels: CMS FY2026 IPPS Tables 6I/6J (MS-DRG v43). Never shown on the clinician panel. https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps
Edition
ICD-10-CM FY2026 guidelines I.A.15, I.C.9.a.2; CMS FY2026 Tables 6I/6J (staff view only)
Effective
from 2025-10-01
Role
CDI staff tab: ladder strip and linkage suggestions for a human coder
Status
draft: encoded from the published source; not yet signed off by a clinical reviewer
Clinical reviewer
—
Coding reviewer
—
Sponsor
none
Body hash
fb90888ec65776194e9b5fd58c973b451f4072b64dc12409453c6cd4a8042281

Thresholds and parameters

{
  "aki_code": {
    "code": "N17.9",
    "label": "Acute kidney failure, unspecified",
    "level": "CC"
  },
  "g_to_code": {
    "G1": "N18.1",
    "G2": "N18.2",
    "G3a": "N18.31",
    "G3b": "N18.32",
    "G4": "N18.4",
    "G5": "N18.5"
  },
  "ladder": [
    {
      "code": "N18.9",
      "label": "Chronic kidney disease, unspecified",
      "level": "non-CC"
    },
    {
      "code": "N18.30",
      "label": "Chronic kidney disease, stage 3 unspecified",
      "level": "non-CC"
    },
    {
      "code": "N18.31",
      "label": "Chronic kidney disease, stage 3a",
      "level": "non-CC"
    },
    {
      "code": "N18.32",
      "label": "Chronic kidney disease, stage 3b",
      "level": "non-CC"
    },
    {
      "code": "N18.4",
      "label": "Chronic kidney disease, stage 4 (severe)",
      "level": "CC"
    },
    {
      "code": "N18.5",
      "label": "Chronic kidney disease, stage 5",
      "level": "CC"
    },
    {
      "code": "N18.6",
      "label": "End stage renal disease",
      "level": "MCC"
    }
  ],
  "linkage": [
    {
      "combination": "E11.22",
      "label": "Type 2 diabetes mellitus with diabetic chronic kidney disease (use additional code for the CKD stage)",
      "when_prefix": "E11"
    },
    {
      "ckd_codes": [
        "N18.1",
        "N18.2",
        "N18.30",
        "N18.31",
        "N18.32",
        "N18.4",
        "N18.9"
      ],
      "combination": "I12.9",
      "label": "Hypertensive CKD with stage 1-4 or unspecified CKD",
      "when_prefix": "I10"
    },
    {
      "ckd_codes": [
        "N18.5",
        "N18.6"
      ],
      "combination": "I12.0",
      "label": "Hypertensive CKD with stage 5 CKD or ESRD",
      "when_prefix": "I10"
    }
  ]
}

Boundary tests: 0/0 pass

None for this rule.