Excludes1 pair
N05- vs N28.9
N05 and N28.9 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
nephropathy NOS with no stated morphological lesion (N28.9)
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
N28.9
Disorder of kidney and ureter, unspecified
BillableUnspecified
- Chapter 14
- Diseases of the genitourinary system
- Section
- N25-N29
Use when the record says
- Nephropathy NOS
- Renal disease (acute) NOS
- Renal insufficiency (acute)
Indexed under
- Inefficiency, kidney
- Nephropathy
- Shutdown, renal
- Block, blocked › kidney
- Cachexia › renal
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