ICD-10-CM Code for History of Nephrectomy
The ICD-10-CM code for a history of nephrectomy is Z90.5 (Acquired absence of kidney).
This code is used to document patients who have undergone surgical removal of one or both kidneys, regardless of the indication for the procedure (whether for cancer, trauma, donation, or other reasons).
Key Coding Considerations
Z90.5 is the appropriate code for documenting prior nephrectomy in the patient's medical record, as it falls under the category of "Persons with potential health hazards related to family and personal history and certain conditions influencing health status" 1.
When to Use This Code
- Post-nephrectomy follow-up visits where the absence of the kidney is clinically relevant
- Documentation of surgical history affecting current treatment decisions
- Risk stratification for patients with solitary kidney function
- Chronic kidney disease monitoring in post-nephrectomy patients, as nephrectomy is an independent risk factor for kidney injury 2
Clinical Context
The documentation of nephrectomy history is particularly important because:
- Patients with prior nephrectomy have increased risk of developing or progressing chronic kidney disease due to nephron loss and hyperfiltration injury in the remaining kidney 2
- Surgical history impacts future treatment decisions, especially if additional renal procedures or nephrotoxic medications are being considered
- Bilateral nephrectomy (Z90.5 with additional documentation) has different implications than unilateral nephrectomy regarding dialysis dependence
Common Documentation Pitfall
Do not confuse Z90.5 with procedure codes used during the active surgical encounter. Z90.5 is specifically for documenting the acquired absence after the procedure has been completed, not for coding the nephrectomy procedure itself. The actual nephrectomy procedures use different codes (such as 1PC58, 1PC89, 1PC91 for kidney procurement/excision) 1.