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Exact Dx synthetic data · demonstration

CDI staff view: kidney findings

For CDI specialists and coders. ICD-10-CM ladders, combination-code linkage and drafted compliant queries are allowed here and never appear on the clinician panel. Rows come from each patient's latest check. No payment estimate is shown anywhere.

Other condition families (criteria library): coder worklist · definitions and reviews.

Clinician panel mode

Current: measurement only (default). Measurement only shows criteria met or not met with lab rows and the rule trace, and never names a diagnosis. Compliant-query mode adds a drafted query (multiple choice, "other" and "unable to determine", every indicator cited) that must pass the linter.

7
Under-documented

Labs meet the criteria; nothing documented.

1
Over-documented

Documented; the criteria are not met.

+6
Net (under − over)

Both directions are reported; neither is hidden in the other.

4
Stage differs

2 stated lower or unstaged · 2 stated higher.

1
Definitions disagree

Not counted either way.

SIMULATED Counts over 28 of 28 synthetic patients' latest checks; a demonstration, not a measured rate.

P05 · Kidney function (eGFR persistence) · UNDER

Clinician-typed Labs meet the criteria; nothing documented criteria met under 2 of 2 eGFR equations (2021 race-free, 2009)

Staff summary: UNDER: nothing documented; computed G3b -> N18.32 (2021 equation); criteria met under 2 of 2 eGFR equations (2021 race-free, 2009).

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC · computed (2021 equation)
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC
Drafted compliant query (blocked by the linter) 
DOCUMENTATION QUERY (draft) for finding RUN-00005.kidney
Title: Clarification request: kidney function
Encounter: KE-P05   Patient: P05   To: author of the draft note
From: (no named sender: sign in to send)
Date: 2026-11-13   Rule versions: ckd_epi_2009@1.0, ckd_epi_2021@1.0, kdigo_aki_2012@1.1, kdigo_ckd_2024@1.1, kidney_compare@1.1, kidney_exclusions@1.0, lab_units@1.1   Check run: RUN-00005

Clinical indicators from the health record:
- Creatinine 1.7 mg/dL on 2026-07-15; eGFR 43.4 mL/min/1.73 m2 (2021 equation), 40.5 (2009 equation) [lab L-0010]
- Creatinine 1.8 mg/dL on 2026-11-12; eGFR 40.5 mL/min/1.73 m2 (2021 equation), 37.8 (2009 equation) [lab L-0011]

Question:
Based on your independent clinical judgement, how would you describe the kidney function findings below in the record?

Response options (select one or write your own):
( ) Chronic kidney disease, stage 3b
( ) Other (please specify): ____________
( ) Unable to determine

Please respond based on your independent clinical judgement. Any response, including "unable to determine", is acceptable. This query and your response are kept as part of the health record.
  • error · no_sender: A query needs a named human sender (sign in).

Run RUN-00005

P06 · Kidney function (eGFR persistence) · UNDER

Clinician-typed Labs meet the criteria; nothing documented criteria met under 2 of 2 eGFR equations (2021 race-free, 2009)

Staff summary: UNDER: nothing documented; computed G3b -> N18.32 (2021 equation); criteria met under 2 of 2 eGFR equations (2021 race-free, 2009).

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC · computed (2021 equation)
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC
Drafted compliant query (blocked by the linter) 
DOCUMENTATION QUERY (draft) for finding RUN-00006.kidney
Title: Clarification request: kidney function
Encounter: KE-P06   Patient: P06   To: author of the draft note
From: (no named sender: sign in to send)
Date: 2026-11-13   Rule versions: ckd_epi_2009@1.0, ckd_epi_2021@1.0, kdigo_aki_2012@1.1, kdigo_ckd_2024@1.1, kidney_compare@1.1, kidney_exclusions@1.0, lab_units@1.1   Check run: RUN-00006

Clinical indicators from the health record:
- Creatinine 1.3 mg/dL on 2026-06-14; eGFR 43.1 mL/min/1.73 m2 (2021 equation), 40.4 (2009 equation) [lab L-0012]
- Creatinine 1.4 mg/dL on 2026-11-11; eGFR 39.5 mL/min/1.73 m2 (2021 equation), 36.9 (2009 equation) [lab L-0013]

Question:
Based on your independent clinical judgement, how would you describe the kidney function findings below in the record?

Response options (select one or write your own):
( ) Chronic kidney disease, stage 3b
( ) Other (please specify): ____________
( ) Unable to determine

Please respond based on your independent clinical judgement. Any response, including "unable to determine", is acceptable. This query and your response are kept as part of the health record.
  • error · no_sender: A query needs a named human sender (sign in).

Run RUN-00006

P07 · Kidney function (eGFR persistence) · UNDER

Clinician-typed Labs meet the criteria; nothing documented criteria met under 2 of 2 eGFR equations (2021 race-free, 2009)

Staff summary: UNDER: nothing documented; computed G4 -> N18.4 (2021 equation); criteria met under 2 of 2 eGFR equations (2021 race-free, 2009).

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC · computed (2021 equation)
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC
Drafted compliant query (blocked by the linter) 
DOCUMENTATION QUERY (draft) for finding RUN-00007.kidney
Title: Clarification request: kidney function
Encounter: KE-P07   Patient: P07   To: author of the draft note
From: (no named sender: sign in to send)
Date: 2026-11-13   Rule versions: ckd_epi_2009@1.0, ckd_epi_2021@1.0, kdigo_aki_2012@1.1, kdigo_ckd_2024@1.1, kidney_compare@1.1, kidney_exclusions@1.0, lab_units@1.1   Check run: RUN-00007

Clinical indicators from the health record:
- Creatinine 2.6 mg/dL on 2026-05-14; eGFR 25.6 mL/min/1.73 m2 (2021 equation), 23.7 (2009 equation) [lab L-0014]
- Creatinine 2.8 mg/dL on 2026-11-10; eGFR 23.4 mL/min/1.73 m2 (2021 equation), 21.7 (2009 equation) [lab L-0015]

Question:
Based on your independent clinical judgement, how would you describe the kidney function findings below in the record?

Response options (select one or write your own):
( ) Chronic kidney disease, stage 4 (severe)
( ) Other (please specify): ____________
( ) Unable to determine

Please respond based on your independent clinical judgement. Any response, including "unable to determine", is acceptable. This query and your response are kept as part of the health record.
  • error · no_sender: A query needs a named human sender (sign in).

Run RUN-00007

P08 · Kidney function (eGFR persistence) · UNDER

AI-drafted Labs meet the criteria; nothing documented criteria met under 2 of 2 eGFR equations (2021 race-free, 2009)

Staff summary: UNDER: nothing documented; computed G3b -> N18.32 (2021 equation); criteria met under 2 of 2 eGFR equations (2021 race-free, 2009).

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC · computed (2021 equation)
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC
Drafted compliant query (blocked by the linter) 
DOCUMENTATION QUERY (draft) for finding RUN-00008.kidney
Title: Clarification request: kidney function
Encounter: KE-P08   Patient: P08   To: author of the draft note
From: (no named sender: sign in to send)
Date: 2026-11-13   Rule versions: ckd_epi_2009@1.0, ckd_epi_2021@1.0, kdigo_aki_2012@1.1, kdigo_ckd_2024@1.1, kidney_compare@1.1, kidney_exclusions@1.0, lab_units@1.1   Check run: RUN-00008

Clinical indicators from the health record:
- Creatinine 1.5 mg/dL on 2026-08-04; eGFR 37.5 mL/min/1.73 m2 (2021 equation), 35.2 (2009 equation) [lab L-0016]
- Creatinine 1.6 mg/dL on 2026-11-12; eGFR 34.7 mL/min/1.73 m2 (2021 equation), 32.5 (2009 equation) [lab L-0017]

Question:
Based on your independent clinical judgement, how would you describe the kidney function findings below in the record?

Response options (select one or write your own):
( ) Chronic kidney disease, stage 3b
( ) Other (please specify): ____________
( ) Unable to determine

Please respond based on your independent clinical judgement. Any response, including "unable to determine", is acceptable. This query and your response are kept as part of the health record.
  • error · no_sender: A query needs a named human sender (sign in).

Run RUN-00008

P15 · Creatinine change during this admission · UNDER

Clinician-typed Labs meet the criteria; nothing documented criteria met under 0 of 4 baselines at admission; 4 of 4 at peak

Staff summary: UNDER: nothing documented; N17.9 ladder applies only if the clinician documents it; criteria met under 0 of 4 baselines at admission; 4 of 4 at peak.

Drafted compliant query (blocked by the linter) 
DOCUMENTATION QUERY (draft) for finding RUN-00015.aki
Title: Clarification request: creatinine change during this admission
Encounter: KE-P15   Patient: P15   To: author of the draft note
From: (no named sender: sign in to send)
Date: 2026-11-13   Rule versions: ckd_epi_2009@1.0, ckd_epi_2021@1.0, kdigo_aki_2012@1.1, kdigo_ckd_2024@1.1, kidney_compare@1.1, kidney_exclusions@1.0, lab_units@1.1   Check run: RUN-00015

Clinical indicators from the health record:
- Creatinine 1.2 mg/dL (2026-11-11 15:00) [lab L-0033]
- Creatinine 1.6 mg/dL (2026-11-12 15:00) [lab L-0034]

Question:
Based on your independent clinical judgement, how would you describe the creatinine change during this admission findings below in the record?

Response options (select one or write your own):
( ) Acute kidney injury
( ) Other (please specify): ____________
( ) Unable to determine

Please respond based on your independent clinical judgement. Any response, including "unable to determine", is acceptable. This query and your response are kept as part of the health record.
  • error · no_sender: A query needs a named human sender (sign in).

Run RUN-00015

P16 · Creatinine change during this admission · UNDER

Clinician-typed Labs meet the criteria; nothing documented criteria met under 1 of 4 baselines at admission; 4 of 4 at peak

Staff summary: UNDER: nothing documented; N17.9 ladder applies only if the clinician documents it; criteria met under 1 of 4 baselines at admission; 4 of 4 at peak.

Drafted compliant query (blocked by the linter) 
DOCUMENTATION QUERY (draft) for finding RUN-00016.aki
Title: Clarification request: creatinine change during this admission
Encounter: KE-P16   Patient: P16   To: author of the draft note
From: (no named sender: sign in to send)
Date: 2026-11-13   Rule versions: ckd_epi_2009@1.0, ckd_epi_2021@1.0, kdigo_aki_2012@1.1, kdigo_ckd_2024@1.1, kidney_compare@1.1, kidney_exclusions@1.0, lab_units@1.1   Check run: RUN-00016

Clinical indicators from the health record:
- Creatinine 1.8 mg/dL (2026-11-11 10:00) [lab L-0037]
- Creatinine 3.9 mg/dL (2026-11-12 07:00) [lab L-0038]
- Creatinine 1.8 mg/dL (2026-08-03 09:00) [lab L-0036]
- Creatinine 1.75 mg/dL (2026-04-25 09:00) [lab L-0035]

Question:
Based on your independent clinical judgement, how would you describe the creatinine change during this admission findings below in the record?

Response options (select one or write your own):
( ) Acute kidney injury
( ) Other (please specify): ____________
( ) Unable to determine

Please respond based on your independent clinical judgement. Any response, including "unable to determine", is acceptable. This query and your response are kept as part of the health record.
  • error · no_sender: A query needs a named human sender (sign in).

Run RUN-00016

P20 · Kidney function (eGFR persistence) · UNDER

AI-drafted Labs meet the criteria; nothing documented criteria met under 2 of 2 eGFR equations (2021 race-free, 2009)

Staff summary: UNDER: nothing documented; computed G3b -> N18.32 (2021 equation); criteria met under 2 of 2 eGFR equations (2021 race-free, 2009).

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC · computed (2021 equation)
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC
Drafted compliant query (blocked by the linter) 
DOCUMENTATION QUERY (draft) for finding RUN-00020.kidney
Title: Clarification request: kidney function
Encounter: KE-P20   Patient: P20   To: author of the draft note
From: (no named sender: sign in to send)
Date: 2026-11-13   Rule versions: ckd_epi_2009@1.0, ckd_epi_2021@1.0, kdigo_aki_2012@1.1, kdigo_ckd_2024@1.1, kidney_compare@1.1, kidney_exclusions@1.0, lab_units@1.1   Check run: RUN-00020

Clinical indicators from the health record:
- Creatinine 1.9 mg/dL on 2026-06-25; eGFR 35.2 mL/min/1.73 m2 (2021 equation), 32.6 (2009 equation) [lab L-0045]
- Creatinine 2.0 mg/dL on 2026-11-12; eGFR 33.1 mL/min/1.73 m2 (2021 equation), 30.6 (2009 equation) [lab L-0046]

Question:
Based on your independent clinical judgement, how would you describe the kidney function findings below in the record?

Response options (select one or write your own):
( ) Chronic kidney disease, stage 3b
( ) Other (please specify): ____________
( ) Unable to determine

Please respond based on your independent clinical judgement. Any response, including "unable to determine", is acceptable. This query and your response are kept as part of the health record.
  • error · no_sender: A query needs a named human sender (sign in).

Run RUN-00020

P28 · Kidney function (eGFR persistence) · UNSUPPORTED

Clinician-typed Documented; the criteria are not met criteria met under 0 of 2 eGFR equations (2021 race-free, 2009)

Staff summary: UNSUPPORTED: documented N18.31; computed no persistent CKD (2021 equation); criteria met under 0 of 2 eGFR equations (2021 race-free, 2009).

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC · documented
  4. N18.32 Chronic kidney disease, stage 3b non-CC
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC
Drafted compliant query (blocked by the linter) 
DOCUMENTATION QUERY (draft) for finding RUN-00028.kidney
Title: Clarification request: kidney function
Encounter: KE-P28   Patient: P28   To: author of the draft note
From: (no named sender: sign in to send)
Date: 2026-11-13   Rule versions: ckd_epi_2009@1.0, ckd_epi_2021@1.0, kdigo_aki_2012@1.1, kdigo_ckd_2024@1.1, kidney_compare@1.1, kidney_exclusions@1.0, lab_units@1.1   Check run: RUN-00028

Clinical indicators from the health record:
- Documented in the record: "CKD stage 3a" [draft note KN-P28-1, characters 48-60]
- Creatinine 0.9 mg/dL on 2026-03-16; eGFR 72.3 mL/min/1.73 m2 (2021 equation), 68.5 (2009 equation) [lab L-0062]
- Creatinine 0.9 mg/dL on 2026-07-14; eGFR 72.3 mL/min/1.73 m2 (2021 equation), 68.5 (2009 equation) [lab L-0063]
- Creatinine 0.95 mg/dL on 2026-11-11; eGFR 67.7 mL/min/1.73 m2 (2021 equation), 64.2 (2009 equation) [lab L-0064]

Question:
Based on your independent clinical judgement, how would you describe the kidney function findings below in the record?

Response options (select one or write your own):
( ) CKD stage 3a: confirmed (please document the supporting clinical information)
( ) CKD stage 3a: ruled out
( ) Other explanation of the clinical findings (please specify): ____________
( ) Unable to determine

Please respond based on your independent clinical judgement. Any response, including "unable to determine", is acceptable. This query and your response are kept as part of the health record.
  • error · no_sender: A query needs a named human sender (sign in).

Run RUN-00028

P11 · Kidney function (eGFR persistence) · SPECIFICITY_GAP

Clinician-typed Stage in the note differs from the computed category criteria met under 2 of 2 eGFR equations (2021 race-free, 2009)

Staff summary: SPECIFICITY_GAP: documented N18.30; computed G4 -> N18.4 (2021 equation); criteria met under 2 of 2 eGFR equations (2021 race-free, 2009).

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC · documented
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC · computed (2021 equation)
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC
Drafted compliant query (blocked by the linter) 
DOCUMENTATION QUERY (draft) for finding RUN-00011.kidney
Title: Clarification request: kidney function
Encounter: KE-P11   Patient: P11   To: author of the draft note
From: (no named sender: sign in to send)
Date: 2026-11-13   Rule versions: ckd_epi_2009@1.0, ckd_epi_2021@1.0, kdigo_aki_2012@1.1, kdigo_ckd_2024@1.1, kidney_compare@1.1, kidney_exclusions@1.0, lab_units@1.1   Check run: RUN-00011

Clinical indicators from the health record:
- Documented in the record: "CKD 3" [draft note KN-P11-1, characters 86-91]
- Creatinine 2.5 mg/dL on 2026-07-04; eGFR 25.8 mL/min/1.73 m2 (2021 equation), 23.9 (2009 equation) [lab L-0022]
- Creatinine 2.7 mg/dL on 2026-11-11; eGFR 23.5 mL/min/1.73 m2 (2021 equation), 21.8 (2009 equation) [lab L-0023]

Question:
Based on your independent clinical judgement, how would you describe the kidney function findings below in the record?

Response options (select one or write your own):
( ) Chronic kidney disease, stage 4 (severe)
( ) Other (please specify): ____________
( ) Unable to determine

Please respond based on your independent clinical judgement. Any response, including "unable to determine", is acceptable. This query and your response are kept as part of the health record.
  • error · no_sender: A query needs a named human sender (sign in).

Run RUN-00011

P12 · Kidney function (eGFR persistence) · SPECIFICITY_GAP

Clinician-typed Stage in the note differs from the computed category criteria met under 2 of 2 eGFR equations (2021 race-free, 2009)

Staff summary: SPECIFICITY_GAP: documented N18.9; computed G4 -> N18.4 (2021 equation); criteria met under 2 of 2 eGFR equations (2021 race-free, 2009).

  1. N18.9 Chronic kidney disease, unspecified non-CC · documented
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC · computed (2021 equation)
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC
Drafted compliant query (blocked by the linter) 
DOCUMENTATION QUERY (draft) for finding RUN-00012.kidney
Title: Clarification request: kidney function
Encounter: KE-P12   Patient: P12   To: author of the draft note
From: (no named sender: sign in to send)
Date: 2026-11-13   Rule versions: ckd_epi_2009@1.0, ckd_epi_2021@1.0, kdigo_aki_2012@1.1, kdigo_ckd_2024@1.1, kidney_compare@1.1, kidney_exclusions@1.0, lab_units@1.1   Check run: RUN-00012

Clinical indicators from the health record:
- Documented in the record: "CKD" [draft note KN-P12-1, characters 90-93]
- Creatinine 1.75 mg/dL on 2026-04-24; eGFR 28.9 mL/min/1.73 m2 (2021 equation), 26.8 (2009 equation) [lab L-0024]
- Creatinine 1.85 mg/dL on 2026-11-10; eGFR 27.1 mL/min/1.73 m2 (2021 equation), 25.1 (2009 equation) [lab L-0025]

Question:
Based on your independent clinical judgement, how would you describe the kidney function findings below in the record?

Response options (select one or write your own):
( ) Chronic kidney disease, stage 4 (severe)
( ) Other (please specify): ____________
( ) Unable to determine

Please respond based on your independent clinical judgement. Any response, including "unable to determine", is acceptable. This query and your response are kept as part of the health record.
  • error · no_sender: A query needs a named human sender (sign in).

Run RUN-00012

P19 · Kidney function (eGFR persistence) · SPECIFICITY_GAP

AI-drafted Stage in the note differs from the computed category criteria met under 2 of 2 eGFR equations (2021 race-free, 2009)

Staff summary: SPECIFICITY_GAP: documented N18.4; computed G3b -> N18.32 (2021 equation); criteria met under 2 of 2 eGFR equations (2021 race-free, 2009).

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC · computed (2021 equation)
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC · documented
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC
Drafted compliant query (blocked by the linter) 
DOCUMENTATION QUERY (draft) for finding RUN-00019.kidney
Title: Clarification request: kidney function
Encounter: KE-P19   Patient: P19   To: author of the draft note
From: (no named sender: sign in to send)
Date: 2026-11-13   Rule versions: ckd_epi_2009@1.0, ckd_epi_2021@1.0, kdigo_aki_2012@1.1, kdigo_ckd_2024@1.1, kidney_compare@1.1, kidney_exclusions@1.0, lab_units@1.1   Check run: RUN-00019

Clinical indicators from the health record:
- Documented in the record: "chronic kidney disease stage 4" [draft note KN-P19-1, characters 140-170]
- Creatinine 1.5 mg/dL on 2026-08-09; eGFR 37.3 mL/min/1.73 m2 (2021 equation), 34.9 (2009 equation) [lab L-0043]
- Creatinine 1.6 mg/dL on 2026-11-12; eGFR 34.5 mL/min/1.73 m2 (2021 equation), 32.3 (2009 equation) [lab L-0044]

Question:
Based on your independent clinical judgement, how would you describe the kidney function findings below in the record?

Response options (select one or write your own):
( ) Chronic kidney disease stage 4: confirmed (please document the supporting clinical information)
( ) Chronic kidney disease, stage 3b
( ) Other explanation of the clinical findings (please specify): ____________
( ) Unable to determine

Please respond based on your independent clinical judgement. Any response, including "unable to determine", is acceptable. This query and your response are kept as part of the health record.
  • error · no_sender: A query needs a named human sender (sign in).

Run RUN-00019

P27 · Kidney function (eGFR persistence) · SPECIFICITY_GAP

AI-drafted Stage in the note differs from the computed category criteria met under 2 of 2 eGFR equations (2021 race-free, 2009)

Staff summary: SPECIFICITY_GAP: documented N18.4; computed G3a -> N18.31 (2021 equation); criteria met under 2 of 2 eGFR equations (2021 race-free, 2009).

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC · computed (2021 equation)
  4. N18.32 Chronic kidney disease, stage 3b non-CC
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC · documented
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC
Drafted compliant query (blocked by the linter) 
DOCUMENTATION QUERY (draft) for finding RUN-00027.kidney
Title: Clarification request: kidney function
Encounter: KE-P27   Patient: P27   To: author of the draft note
From: (no named sender: sign in to send)
Date: 2026-11-13   Rule versions: ckd_epi_2009@1.0, ckd_epi_2021@1.0, kdigo_aki_2012@1.1, kdigo_ckd_2024@1.1, kidney_compare@1.1, kidney_exclusions@1.0, lab_units@1.1   Check run: RUN-00027

Clinical indicators from the health record:
- Documented in the record: "Chronic kidney disease stage 4" [draft note KN-P27-1, characters 249-279]
- Creatinine 1.45 mg/dL on 2026-07-17; eGFR 51.5 mL/min/1.73 m2 (2021 equation), 48.1 (2009 equation) [lab L-0060]
- Creatinine 1.55 mg/dL on 2026-11-12; eGFR 47.6 mL/min/1.73 m2 (2021 equation), 44.4 (2009 equation) [lab L-0061]

Question:
Based on your independent clinical judgement, how would you describe the kidney function findings below in the record?

Response options (select one or write your own):
( ) Chronic kidney disease stage 4: confirmed (please document the supporting clinical information)
( ) Chronic kidney disease, stage 3a
( ) Other explanation of the clinical findings (please specify): ____________
( ) Unable to determine

Please respond based on your independent clinical judgement. Any response, including "unable to determine", is acceptable. This query and your response are kept as part of the health record.
  • error · no_sender: A query needs a named human sender (sign in).

Run RUN-00027

P13 · Kidney function (eGFR persistence) · DEFINITIONS_DISAGREE

Clinician-typed Definitions disagree; the tool does not choose criteria met under 1 of 2 eGFR equations (2021 race-free, 2009)

Staff summary: DEFINITIONS_DISAGREE: documented N18.31; computed no persistent CKD (2021 equation); criteria met under 1 of 2 eGFR equations (2021 race-free, 2009).

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC · documented
  4. N18.32 Chronic kidney disease, stage 3b non-CC
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC
Drafted compliant query (blocked by the linter) 
DOCUMENTATION QUERY (draft) for finding RUN-00013.kidney
Title: Clarification request: kidney function
Encounter: KE-P13   Patient: P13   To: author of the draft note
From: (no named sender: sign in to send)
Date: 2026-11-13   Rule versions: ckd_epi_2009@1.0, ckd_epi_2021@1.0, kdigo_aki_2012@1.1, kdigo_ckd_2024@1.1, kidney_compare@1.1, kidney_exclusions@1.0, lab_units@1.1   Check run: RUN-00013

Clinical indicators from the health record:
- Documented in the record: "CKD stage 3a (from an outside lab report)" [encounter diagnosis list]
- Creatinine 1.28 mg/dL on 2026-07-15; eGFR 62.1 mL/min/1.73 m2 (2021 equation), 58.3 (2009 equation) [lab L-0026]
- Creatinine 1.3 mg/dL on 2026-11-12; eGFR 61.0 mL/min/1.73 m2 (2021 equation), 57.3 (2009 equation) [lab L-0027]

Question:
Based on your independent clinical judgement, how would you describe the kidney function findings below in the record?

Response options (select one or write your own):
( ) CKD stage 3a (from an outside lab report): confirmed (please document the supporting clinical information)
( ) CKD stage 3a (from an outside lab report): ruled out
( ) Other explanation of the clinical findings (please specify): ____________
( ) Unable to determine

Please respond based on your independent clinical judgement. Any response, including "unable to determine", is acceptable. This query and your response are kept as part of the health record.
  • error · no_sender: A query needs a named human sender (sign in).

Run RUN-00013

P09 · Kidney function (eGFR persistence) · NOT_ASSESSABLE

Clinician-typed Not assessable: the data cannot decide not assessable

Staff summary: NOT_ASSESSABLE: documented N18.30; one value below 60 (eGFR 53.6 on 2026-11-11); persistence needs a repeat at least 90 days later.

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC · documented
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC

Run RUN-00009

P10 · Kidney function (eGFR persistence) · NOT_ASSESSABLE

Clinician-typed Not assessable: the data cannot decide not assessable

Staff summary: NOT_ASSESSABLE: documented N18.32; one value below 60 (eGFR 45.4 on 2026-11-12) since the last value of 60 or more; persistence needs a repeat at least 90 days later.

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC · documented
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC

Run RUN-00010

P15 · Kidney function (eGFR persistence) · NOT_ASSESSABLE

Clinician-typed Not assessable: the data cannot decide not assessable

Staff summary: NOT_ASSESSABLE: nothing documented; no steady-state creatinine result on file.

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC

Run RUN-00015

P21 · Kidney function (eGFR persistence) · NOT_ASSESSABLE

Clinician-typed Not assessable: the data cannot decide not assessable

Staff summary: NOT_ASSESSABLE: nothing documented; maintenance dialysis on record (problem list, since 2024-09-02): creatinine reflects the dialysis schedule, not kidney filtering.

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC

Run RUN-00021

P22 · Kidney function (eGFR persistence) · NOT_ASSESSABLE

Clinician-typed Not assessable: the data cannot decide not assessable

Staff summary: NOT_ASSESSABLE: nothing documented; kidney transplant on record (procedure history, since 2021-05-20): staging and acute change in a transplanted kidney follow transplant-specific assessment.

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC

Run RUN-00022

P23 · Kidney function (eGFR persistence) · NOT_ASSESSABLE

AI-drafted Not assessable: the data cannot decide not assessable

Staff summary: NOT_ASSESSABLE: nothing documented; pregnancy on record (problem list, since 2026-05-16): the estimating equations and creatinine thresholds are not validated in pregnancy.

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC

Run RUN-00023

P24 · Kidney function (eGFR persistence) · NOT_ASSESSABLE

Clinician-typed Not assessable: the data cannot decide not assessable

Staff summary: NOT_ASSESSABLE: nothing documented; limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering.

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC

Run RUN-00024

P25 · Creatinine change during this admission · NOT_ASSESSABLE

Clinician-typed Not assessable: the data cannot decide criteria met under 0 of 4 baselines at admission; 0 of 4 at peak

Staff summary: NOT_ASSESSABLE: documented N17.9; no creatinine before admission and no 48-hour rise or fall during the stay; the back-calculated baseline is never used alone.

Run RUN-00025

P25 · Kidney function (eGFR persistence) · NOT_ASSESSABLE

Clinician-typed Not assessable: the data cannot decide not assessable

Staff summary: NOT_ASSESSABLE: nothing documented; fewer than two values of 60 or more at least 90 days apart.

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC

Run RUN-00025

P26 · Kidney function (eGFR persistence) · NOT_ASSESSABLE

Clinician-typed Not assessable: the data cannot decide not assessable

Staff summary: NOT_ASSESSABLE: nothing documented; no steady-state creatinine result on file.

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC

Run RUN-00026

P01 · Kidney function (eGFR persistence) · CONSISTENT

Clinician-typed Note and criteria agree criteria met under 2 of 2 eGFR equations (2021 race-free, 2009)

Staff summary: CONSISTENT: documented N18.32; computed G3b -> N18.32 (2021 equation); criteria met under 2 of 2 eGFR equations (2021 race-free, 2009).

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC · documented · computed (2021 equation)
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC

Run RUN-00001

P14 · Creatinine change during this admission · CONSISTENT

Clinician-typed Note and criteria agree criteria met under 2 of 4 baselines at admission; 4 of 4 at peak

Staff summary: CONSISTENT: documented N17.9; N17.9 ladder applies only if the clinician documents it; criteria met under 2 of 4 baselines at admission; 4 of 4 at peak.

Run RUN-00014

P16 · Kidney function (eGFR persistence) · CONSISTENT

Clinician-typed Note and criteria agree criteria met under 2 of 2 eGFR equations (2021 race-free, 2009)

Staff summary: CONSISTENT: documented N18.32; computed G3b -> N18.32 (2021 equation); criteria met under 2 of 2 eGFR equations (2021 race-free, 2009).

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC · documented · computed (2021 equation)
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC

Run RUN-00016

P17 · Kidney function (eGFR persistence) · CONSISTENT

Clinician-typed Note and criteria agree criteria met under 2 of 2 eGFR equations (2021 race-free, 2009)

Staff summary: CONSISTENT: documented N18.32; computed G3b -> N18.32 (2021 equation); criteria met under 2 of 2 eGFR equations (2021 race-free, 2009).

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC
  4. N18.32 Chronic kidney disease, stage 3b non-CC · documented · computed (2021 equation)
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC

Linkage (ICD-10-CM "with" convention): E11.22 with N18.32, because E11.9 is on the encounter list. Type 2 diabetes mellitus with diabetic chronic kidney disease (use additional code for the CKD stage).

Run RUN-00017

P18 · Kidney function (eGFR persistence) · CONSISTENT

Clinician-typed Note and criteria agree criteria met under 2 of 2 eGFR equations (2021 race-free, 2009)

Staff summary: CONSISTENT: documented N18.31; computed G3a -> N18.31 (2021 equation); criteria met under 2 of 2 eGFR equations (2021 race-free, 2009).

  1. N18.9 Chronic kidney disease, unspecified non-CC
  2. N18.30 Chronic kidney disease, stage 3 unspecified non-CC
  3. N18.31 Chronic kidney disease, stage 3a non-CC · documented · computed (2021 equation)
  4. N18.32 Chronic kidney disease, stage 3b non-CC
  5. N18.4 Chronic kidney disease, stage 4 (severe) CC
  6. N18.5 Chronic kidney disease, stage 5 CC
  7. N18.6 End stage renal disease MCC

Linkage (ICD-10-CM "with" convention): I12.9 with N18.31, because I10 is on the encounter list. Hypertensive CKD with stage 1-4 or unspecified CKD.

Run RUN-00018

P26 · Creatinine change during this admission · CONSISTENT

Clinician-typed Note and criteria agree criteria met under 1 of 4 baselines at admission; 1 of 4 at peak; reverse comparison met (2.0x the lowest value in the following 7 days)

Staff summary: CONSISTENT: documented N17.9; N17.9 ladder applies only if the clinician documents it; criteria met under 1 of 4 baselines at admission; 1 of 4 at peak; reverse comparison met (2.0x the lowest value in the following 7 days).

Run RUN-00026