Chronic kidney disease, Stage IV (severe)

This code signifies a severe and irreversible decline in kidney function, characterized by a glomerular filtration rate (GFR) between 15 and 29 mL/min/1.73 m². Patients at this stage often experience significant symptoms of uremia and require close monitoring for progression to end-stage renal disease.

Assign this code when documentation explicitly states "chronic kidney disease, Stage IV" or "severe CKD," supported by a GFR in the 15-29 mL/min range. This code is appropriate for patients with established, long-standing kidney dysfunction meeting these criteria.

• Always sequence this code after any underlying cause of the CKD (e.g., diabetes, hypertension).
• Do not use this code for acute kidney injury or transient renal insufficiency.
• Ensure the physician's documentation clearly specifies "Stage IV" or "severe" CKD, along with supporting GFR values if available.