FY2027
MenuClose
Excludes1 pair

N05- vs N12

N05 and N12 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.

The official note, declared on N05
tubulo-interstitial nephritis NOS (N12)
N05

Unspecified nephritic syndrome

Not billable
Chapter 14
Diseases of the genitourinary system
Section
N00-N08
Use when the record says
  • glomerular disease NOS
  • glomerulonephritis NOS
  • nephritis NOS
  • nephropathy NOS and renal disease NOS with morphological lesion specified in .0-.8
N12

Tubulo-interstitial nephritis, not specified as acute or chronic

Billable
Chapter 14
Diseases of the genitourinary system
Section
N10-N16
Use when the record says
  • Interstitial nephritis NOS
  • Pyelitis NOS
  • Pyelonephritis NOS
Indexed under
  • Pyonephritis
  • Nephritis, nephritic › antitubular basement membrane NEC (tubulo-interstitial)
  • Nephritis, nephritic › tubulo-interstitial (in)
  • Pyelonephritis › nonobstructive
  • Disease, diseased › antiglomerular basement membrane antibody › tubulo-interstitial nephritis

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