CCM · Nephrology
CCM Qualifying Diagnoses
for Nephrology.
25 ICD-10 codes qualify nephrology patients for Chronic Care Management (CCM).
Qualifying Codes
ICD-10 codes for nephrology.
Anemia
1 codeAnemia in chronic kidney disease
Anemia in chronic kidney disease
Autoimmune
1 codeSystemic lupus erythematosus, unspecified
Systemic lupus erythematosus, unspecified
Cancer
1 codeMalignant neoplasm of kidney, unspecified
Malignant neoplasm of kidney, unspecified
Chronic Kidney Disease
9 codesChronic kidney disease, stage 1
Chronic kidney disease, stage 1
Chronic kidney disease, stage 2 (mild)
Chronic kidney disease, stage 2 (mild)
Chronic kidney disease, stage 3 unspecified
BP + weight monitoring; fluid management critical
Chronic kidney disease, stage 3 unspecified
BP + weight monitoring; fluid management critical
Chronic kidney disease, stage 3a
Chronic kidney disease, stage 3a
Chronic kidney disease, stage 3b
Chronic kidney disease, stage 3b
Chronic kidney disease, stage 4 (severe)
Pre-dialysis monitoring; aggressive BP and fluid control
Chronic kidney disease, stage 4 (severe)
Pre-dialysis monitoring; aggressive BP and fluid control
Chronic kidney disease, stage 5
ESRD pre-dialysis or post-transplant monitoring
Chronic kidney disease, stage 5
ESRD pre-dialysis or post-transplant monitoring
End stage renal disease
End stage renal disease
Chronic kidney disease, unspecified
Chronic kidney disease, unspecified
Hypertension
5 codesEssential (primary) hypertension
Most common RPM diagnosis; twice-daily BP monitoring recommended
Essential (primary) hypertension
Most common RPM diagnosis; twice-daily BP monitoring recommended
Hypertensive chronic kidney disease, stage 1–4/unspecified
Hypertensive chronic kidney disease, stage 1–4/unspecified
Hypertensive heart and CKD without heart failure, stage 1–4/unspecified
Hypertensive heart and CKD without heart failure, stage 1–4/unspecified
Renovascular hypertension
Renovascular hypertension
Other secondary hypertension
Other secondary hypertension
Other Renal
3 codesNephrotic syndrome, unspecified
Nephrotic syndrome, unspecified
Unspecified nephritic syndrome, unspecified
Unspecified nephritic syndrome, unspecified
Acute kidney failure, unspecified
Post-AKI monitoring for progression to CKD
Acute kidney failure, unspecified
Post-AKI monitoring for progression to CKD
Type 1 Diabetes
2 codesType 1 diabetes mellitus with diabetic nephropathy
Type 1 diabetes mellitus with diabetic nephropathy
Type 1 diabetes mellitus with diabetic chronic kidney disease
Type 1 diabetes mellitus with diabetic chronic kidney disease
Type 2 Diabetes
3 codesType 2 diabetes mellitus with diabetic nephropathy
Type 2 diabetes mellitus with diabetic nephropathy
Type 2 diabetes mellitus with diabetic chronic kidney disease
Type 2 diabetes mellitus with diabetic chronic kidney disease
Type 2 diabetes mellitus with other diabetic kidney complication
Type 2 diabetes mellitus with other diabetic kidney complication
Clinical Context
Why nephrology practices benefit from CCM.
Nephrology practices can leverage CCM to improve patient outcomes through structured care management, generating $97–$220+ per patient per month in Medicare reimbursement while reducing avoidable hospitalizations.
Related Conditions
Condition monitoring guides.
FAQ
Common questions.
What ICD-10 codes qualify nephrology patients for CCM?
There are 25 ICD-10 codes that qualify nephrology patients for Chronic Care Management (CCM). These include codes across 8 diagnosis categories: Anemia, Autoimmune, Cancer, Chronic Kidney Disease, Hypertension, Other Renal, Type 1 Diabetes, Type 2 Diabetes.
How does CCN Health support nephrology practices with CCM?
CCN Health provides turnkey CCM services for nephrology practices — including patient eligibility identification, enrollment documentation, device provisioning, clinical monitoring, and full Medicare billing support. Most practices are fully operational within 1 week.
What is the revenue potential for CCM in nephrology?
CCM generates $62–149 per patient per month in Medicare reimbursement. Nephrology practices with a high prevalence of qualifying conditions can scale rapidly, especially when CCM is stacked with other eligible programs like RPM and BHI.