Excludes1 pair
N05.5 vs N05.A
N05.5 and N05.A are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.
N05.5
Unspecified nephritic syndrome with diffuse mesangiocapillary glomerulonephritis
BillableUnspecified
- Chapter 14
- Diseases of the genitourinary system
- Section
- N00-N08
Use when the record says
- Unspecified nephritic syndrome with membranoproliferative glomerulonephritis, types 1 and 3, or NOS
Indexed under
- Glomerulonephritis › membranoproliferative (diffuse)(type 1 or 3)
- Glomerulonephritis › mesangiocapillary NEC (diffuse)
- Nephritis, nephritic › membranoproliferative (diffuse) (type 1 or 3)
- Glomerulonephritis › diffuse › mesangiocapillary
- Nephritis, nephritic › with › diffuse › mesangiocapillary glomerulonephritis
N05.A
Unspecified nephritic syndrome with C3 glomerulonephritis
BillableUnspecified
- Chapter 14
- Diseases of the genitourinary system
- Section
- N00-N08
Use when the record says
- Unspecified nephritic syndrome with C3 glomerulopathy
Indexed under
- Glomerulonephritis › with › C3 › glomerulonephritis
- Glomerulonephritis › with › C3 › glomerulopathy
- Nephritis, nephritic › with › C3 › glomerulonephritis
- Nephritis, nephritic › with › C3 › glomerulopathy
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027