| Rating
|
---|
Renal dysfunction:
| |
Chronic kidney disease with glomerular filtration rate (GFR) less than 15 mL/min/1.73 m
2 for at least 3 consecutive months during the past 12 months; or requiring regular routine dialysis; or eligible kidney transplant recipient | 100
|
Chronic kidney disease with GFR from 15 to 29 mL/min/1.73 m
2 for at least 3 consecutive months during the past 12 months | 80
|
Chronic kidney disease with GFR from 30 to 44 mL/min/1.73 m
2 for at least 3 consecutive months during the past 12 months | 60
|
Chronic kidney disease with GFR from 45 to 59 mL/min/1.73 m
2 for at least 3 consecutive months during the past 12 months | 30
|
GFR from 60 to 89 mL/min/1.73 m
2 and either recurrent red blood cell (RBC) casts, white blood cell (WBC) casts, or granular casts for at least 3 consecutive months during the past 12 months; or
| |
GFR from 60 to 89 mL/min/1.73 m
2 and structural kidney abnormalities (cystic, obstructive, or glomerular) for at least 3 consecutive months during the past 12 months; or
| |
GFR from 60 to 89 mL/min/1.73 m
2 and albumin/creatinine ratio (ACR) ≥30 mg/g for at least 3 consecutive months during the past 12 months | 0
|
Note: GFR, estimated GFR (eGFR), and creatinine-based approximations of GFR will be accepted for evaluation purposes under this section when determined to be appropriate and calculated by a medical professional.
| |
Voiding dysfunction:
| |
Rate particular condition as urine leakage, frequency, or obstructed voiding |
|
Continual Urine Leakage, Post Surgical Urinary Diversion, Urinary Incontinence, or Stress Incontinence:
| |
Requiring the use of an appliance or the wearing of absorbent materials which must be changed more than 4 times per day | 60
|
Requiring the wearing of absorbent materials which must be changed 2 to 4 times per day | 40
|
Requiring the wearing of absorbent materials which must be changed less than 2 times per day | 20
|
Urinary frequency:
| |
Daytime voiding interval less than one hour, or; awakening to void five or more times per night | 40
|
Daytime voiding interval between one and two hours, or; awakening to void three to four times per night | 20
|
Daytime voiding interval between two and three hours, or; awakening to void two times per night | 10
|
Obstructed voiding:
| |
Urinary retention requiring intermittent or continuous catheterization | 30
|
Marked obstructive symptomatology (hesitancy, slow or weak stream, decreased force of stream) with any one or combination of the following:
| |
1. Post void residuals greater than 150 cc.
| |
2. Uroflowmetry; markedly diminished peak flow rate (less than 10 cc/sec).
| |
3. Recurrent urinary tract infections secondary to obstruction.
| |
4. Stricture disease requiring periodic dilatation every 2 to 3 months | 10
|
Obstructive symptomatology with or without stricture disease requiring dilatation 1 to 2 times per year | 0
|
Urinary tract infection:
| |
Poor renal function: Rate as renal dysfunction.
| |
Recurrent symptomatic infection requiring drainage by stent or nephrostomy tube; or requiring greater than 2 hospitalizations per year; or requiring continuous intensive management | 30
|
Recurrent symptomatic infection requiring 1-2 hospitalizations per year or suppressive drug therapy lasting six months or longer | 10
|
Recurrent symptomatic infection not requiring hospitalization, but requiring suppressive drug therapy for less than 6 months | 0 |