ICD-9 Code 585.4

Chronic kidney disease, Stage IV (severe)

Not Valid for Submission

585.4 is a legacy non-billable code used to specify a medical diagnosis of chronic kidney disease, stage iv (severe). This code was replaced on September 30, 2015 by its ICD-10 equivalent.

ICD-9: 585.4
Short Description:Chr kidney dis stage IV
Long Description:Chronic kidney disease, Stage IV (severe)

Convert 585.4 to ICD-10

The following crosswalk between ICD-9 to ICD-10 is based based on the General Equivalence Mappings (GEMS) information:

  • N18.4 - Chronic kidney disease, stage 4 (severe)

Code Classification

  • Diseases of the genitourinary system (580–629)
    • Nephritis, nephrotic syndrome, and nephrosis (580-589)
      • 585 Chronic renal failure

Information for Medical Professionals

Index to Diseases and Injuries

References found for the code 585.4 in the Index of Diseases and Injuries:


Information for Patients


Chronic Kidney Disease

Also called: CKD

You have two kidneys, each about the size of your fist. Their main job is to filter wastes and excess water out of your blood to make urine. They also keep the body's chemical balance, help control blood pressure, and make hormones.

Chronic kidney disease (CKD) means that your kidneys are damaged and can't filter blood as they should. This damage can cause wastes to build up in your body. It can also cause other problems that can harm your health. Diabetes and high blood pressure are the most common causes of CKD.

Treatment may include medicines to lower blood pressure, control blood glucose, and lower blood cholesterol. CKD can get worse over time. CKD may lead to kidney failure. The only treatment options for kidney failure are dialysis or a kidney transplantation.

You can take steps to keep your kidneys healthier longer:

  • Choose foods with less salt (sodium)
  • Keep your blood pressure below 130/80
  • Keep your blood glucose in the target range, if you have diabetes

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

  • 24-hour urine protein
  • ACE inhibitors
  • Albumin - serum
  • Basic metabolic panel
  • BUN
  • Chronic Kidney Disease and Medicines: What You Need to Know - NIH (National Kidney Disease Education Program)
  • Chronic Kidney Disease-Mineral and Bone Disorder - NIH (National Institute of Diabetes and Digestive and Kidney Diseases)
  • Creatinine - urine
  • Glomerular filtration rate
  • Kidney biopsy
  • Medicines and Kidney Disease - NIH (National Kidney Disease Education Program)
  • Microalbuminuria test
  • Phosphorus: Tips for People with Chronic Kidney Disease (CKD) - NIH (National Kidney Disease Education Program)
  • Potassium: Tips for People with Chronic Kidney Disease (CKD) - NIH (National Kidney Disease Education Program)
  • Protein: Tips for People with Chronic Kidney Disease (CKD) - NIH (National Kidney Disease Education Program)
  • Renal arteriography
  • Renal perfusion scintiscan
  • Renal scan
  • Renovascular hypertension
  • Sodium: Tips for People with Chronic Kidney Disease (CKD) - NIH (National Kidney Disease Education Program)
  • Urinary casts
  • You, Your Blood Pressure, and Your Kidneys (American Kidney Fund)

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ICD-9 Footnotes

General Equivalence Map Definitions
The ICD-9 and ICD-10 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.

Index of Diseases and Injuries Definitions

  • And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
  • Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
  • Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
  • Type 1 Excludes Notes - A type 1 Excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • Type 2 Excludes Notes - A type 2 Excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
  • Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
  • Inclusion terms - List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
  • NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
  • NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
  • See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
  • See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
  • 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
  • With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.