Cardiovascular-Kidney-Metabolic Syndrome: Development of an ICD-10-CM Coding Framework.

Area of Science:

• Cardiovascular medicine
• Nephrology
• Metabolic disease research
• Health informatics

Background:

• Cardiovascular-Kidney-Metabolic (CKM) syndrome links cardiometabolic risk factors, chronic kidney disease (CKD), and cardiovascular disease.
• The American Heart Association (AHA) proposed CKM stages (0-4) for risk stratification.
• Lack of a single ICD-10-CM code hinders standardized CKM stage identification in health records.

Purpose of the Study:

• To develop an AHA-aligned ICD-10-CM coding framework.
• To operationalize CKM stages 0-4 for reproducible cohort identification.
• To support stage-based analyses in real-world data.

Main Methods:

• Mapped AHA CKM stages (0-4) to ICD-10-CM diagnosis codes.
• Utilized Fiscal Year 2026 conventions and code-set engineering best practices.
• Defined a hierarchical staging algorithm, co-occurrence rules, and encounter thresholds.

Main Results:

• Provided stage-specific ICD-10-CM code sets for CKM stages 0-4.
• Stage 1: excess adiposity/prediabetes; Stage 2: metabolic disease/early CKD.
• Stage 3: subclinical cardiovascular injury/high-risk CKD; Stage 4: overt cardiovascular disease/kidney failure.

Conclusions:

• The framework enables transparent, reproducible CKM staging in real-world datasets.
• Supports stage-based epidemiologic and health-system applications.
• Requires empirical validation and local testing before clinical deployment.