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• Removes waste products from the blood.
• Produces and eliminates urine
• Kidneys produce the hormone Erythropoietin (eri-thro-poi-tin) (EPO)
• Stimulates the production of red blood cells within the bone marrow.
• Kidneys produce the enzyme Renin
• Aids in the raising of the blood pressure
• Kidneys receive 20-25% of total cardiac output. Kidneys receive blood through renal
artery.
• 1200ml of blood flows through kidneys each minute.
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• The bean-shaped kidneys lie in a retroperitoneal position in the superior lumbar region and
extend from the twelfth thoracic to the third lumbar vertebrae.
• The right kidney is lower that the left because it is crowded by the liver.
• The lateral surface is convex and the medial surface is concave, with a vertical cleft called
the renal hilus leading to the renal sinus.
• Ureters, renal blood vessels, lymphatic's, and nerves enter and exit at the hilus.
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Functional unit of the kidney.
1 million nephrons
Consists of: Renal corpuscle and a Renal tubule
Corpuscle consists of a glomerulus and glomerular
capsule
• Portions of the renal tubule include the nephron
loop (loop of Henle ascending and descending
limbs and the distal convoluted tubules.
• Nephrons join a collecting duct which empties into
the minor calyx of the renal pelvis
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Glomerulonephritis (Acute)
(gloh-mair-yoo-loh-neh-FRYE-tis)
• An inflammation of the glomerulus of the kidneys. Condition characterized by
proteinuria, hematuria and decreased urine production
 ICD-9-CM: 583.9
 ICD-10-CM: N05.9 Unspecified nephritic syndrome with unspecified morphologic changes
lesions
N06.9 Isolated proteinuria with unspecified morphologic lesion
N07.9 Hereditary nephropathy, not elsewhere classified with unspecified morphologic
N15.9 Renal tubulo-interstitial disease, unspecified
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(high-droh-neh-afroh-sis)
Distension of the pelvis and calyces of the kidney caused by urine that cannot flow past an
obstruction in a ureters.
ICD 9 CM: 591
ICD 10 CM : N13.1 Hydronephrosis with ureteral stricture, not elsewhere classified
N13.2 Hydronephrosis with renal and ureteral calculous obstruction
N13.30 Unspecified hydronephrosis
N13.39 Other hydronephrosis
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Nephritis
• Nephritis (nef-RY-tis) is an inflammation of one or both kidneys that can result in kidney
damage.
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Renal Calculus
 (REE-nal KAW-kew-lus) as known as Nephrolithiasis
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Stone formations in the kidneys
 ICD-9-CM: 592.0 Calculus of kidney
592.1 Calculus of ureter
592.9 Unspecified urinary calculus
 ICD-10-CM: N20.0 Calculus of kidney
N20.2 Calculus of kidney with calculus of ureter
N20.1 Calculus of ureter
N20.9 Urinary calculus, unspecified
N22 Calculus of urinary tract in diseases classified elsewhere
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Renal Calculus
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 (REE-nal SELL car-sin-OH-mah)
– A malignant tumor of the kidney occurring adulthood.
• Patients is asymptomatic (symptom free) until the later stages of the disease
 ICD-9-CM: 189.0 Malignant neoplasm of kidney, except pelvis
189.1 Malignant neoplasm of renal pelvis
 ICD-10-CM C64.1 Malignant neoplasm of right kidney, except renal pelvis
C64.2 Malignant neoplasm of left kidney, except renal pelvis
C64.9 Malignant neoplasm of unspecified kidney, except renal pelvis
C65.1 Malignant neoplasm of right renal pelvis
C65.2 Malignant neoplasm of left renal pelvis
C65.9 Malignant neoplasm of unspecified renal pelvis
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Renal Cell Carcinoma
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Nephrotic Syndrome
(neh-FROT-ic SIN-drohm) is not a separate disease, but a collection of
symptoms caused by many diseases that affect the kidneys, resulting
in severe, prolonged loss of protein into the urine, decreased levels of
protein in the blood, retention of excess salt and water in the body, and
increased levels of fats (lipids) in the blood.
 ICD-9-CM: Diagnosis Code Range:581- 581.9
 ICD-10-CM: Diagnosis Code Range maps to 27 possible codes
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Pyelonephritis
• (pye-eh-loh-neh-FRY-it is) an inflammation of the kidney, is the most common form of
kidney disease. Most cases are caused by a bacterial infection that starts in the bladder
and spreads to the kidney. Sometimes an obstruction that interferes with the flow of
urine in the urinary tract can cause the disease. Symptoms of pyelonephritis include
fever, chills, and back pain. Pyelonephritis can be acute or chronic.
ICD-9-CM:
ICD-10-CM:
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Pyelonephritis
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Stages of Kidney Failure
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Stages of Renal Failure
ICD 9 CM:
585.1 Chronic kidney disease, Stage I
585.2 Chronic kidney disease, Stage II (mild)
585.3 Chronic kidney disease, Stage III (moderate)
585.4 Chronic kidney disease, Stage IV (severe)
585.5 Chronic kidney disease, Stage V
585.6 End stage renal disease
585.9 Chronic kidney disease, unspecified
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Stages of Renal Failure
ICD 10 CM:
N18.1 Chronic kidney disease, stage 1
N18.2 Chronic kidney disease, stage 2 (mild)
N18.3 Chronic kidney disease, stage 3 (moderate)
N18.4 Chronic kidney disease, stage 4 (severe)
N18.5 Chronic kidney disease, stage 5
N18.6 End stage renal disease
N18.9 Chronic kidney disease, unspecified
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Horseshoe Kidney
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Horseshoe Kidney
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Diagnostic Radiology Procedures
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CPT® 74000
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CPT ® Code(s)
74400 – 74420
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Ultrasonography
Procedure in which sound waves
are transmitted into the body
structures as a small transducer is
passed over the patient’s skin
Also called ultrasound
CPT ® 76775 - Kidney
76776 -Transplanted Kidney
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Renal Scan – Nuclear Medicine
 A specialized scan used to assess the
function and structure of the kidneys, as
well as the perfusion (blood flow) to the
kidney tissue.
Procedure in which a radioactive isotope
(tracer) is injected intravenously, and the
radioactivity over each kidney is measured
as the tracer passes through the kidney.
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CT, CTA, MRI & MRA Scans
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PET/CT Scan
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Renal Angiography
Renal angiography sports four new codes effective Jan. 1, 2012. Key
elements distinguishing the codes include whether the service is first
order or higher and whether the service is unilateral or bilateral:
G0275 - Renal angiography, non-selective, one or both kidneys,
performed at the same time as cardiac catheterization and/or coronary
angiography.
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 36251® - Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for
renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast injection(s),
image post processing, permanent recording of images, and radiological supervision and interpretation,
including pressure gradient measurements when performed, and flush aortogram when performed; unilateral
 36252® - ... bilateral
 36253® - Superselective catheter placement (one or more second order or higher renal artery branches) renal
artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheterization,
fluoroscopy, contrast injection(s), image post processing, permanent recording of images, and radiological
supervision and interpretation, including pressure gradient measurements when performed, and flush
aortogram when performed; unilateral
 36254® - ... bilateral.
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Renal Arteriogram
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Renal Venogram
36011-Selective catheter placement, venous system; first order branch (e.g., renal vein,
jugular vein)
36012 Selective catheter placement, venous system second order branch
75831-Venography, renal, unilateral, selective, radiological supervision and interpretation
75833-Venography, renal, bilateral, selective, radiological supervision and interpretation
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Renin Procedure
• This is another test for diagnosing renovascular hypertension, and is performed in the
Radiology department.
• Seldinger technique
• Catheter used to collect venous blood sample.
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Extracorporeal Lithotripsy
Noninvasive mechanical procedure for breaking up renal calculi so
they pass through the ureters
• Also known as Extracorporeal Shock Wave Lithotripsy
CPT® 50590 - Lithotripsy, extracorporeal shockwave
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Extracorporeal Lithotripsy
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Percutaneous Nephrolithotomy
CPT ® 50081 (Percutaneous nephrostolithotomy
or pyelostolithotomy, with or
without dilation, endoscopy,
lithotripsy, stenting or basket
extraction; over 2 cm)
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Percutaneous Nephrostomy or Nephropyelostomy is an
Interventional procedure used to decompress the renal
collecting system.
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CPT ® 50390 - Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous
For radiological supervision and interpretation, see 74425, 74470, 76942, 77002, 77012,
77021 ®
CPT ® 50392 - Introduction of intracatheter or catheter into renal pelvis for drainage and/or
injection, percutaneous
For radiological supervision and interpretation, see 74475, 76942, 77012 ® . Does not include
antegrade pyelogram
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Double Stents
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Radiofrequency Ablation
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Cryo-Chemo Ablation
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Transcatheter Embolization
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Chemotherapy Embolization
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Kidney Biopsy
• Fine Needle
- CPT ® 10022
• Core
- CPT ® 50200
(For radiological supervision and
interpretation, see 76942, 77002,
77012, 77021 ®)
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Renal Artery Angioplasty
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Angioplasty and Stent
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[email protected]
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