Excludes1 pair

N06.5 vs N06.A

N06.5 and N06.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.

The official note, declared on N06.5
Isolated proteinuria with C3 glomerulonephritis (N06.A)
N06.5

Isolated proteinuria with diffuse mesangiocapillary glomerulonephritis

Billable
Chapter 14
Diseases of the genitourinary system
Section
N00-N08
Use when the record says
  • Isolated proteinuria with membranoproliferative glomerulonephritis, types 1 and 3, or NOS
Indexed under
  • Proteinuria › isolated › with glomerular lesion › diffuse › mesangiocapillary glomerulonephritis
N06.A

Isolated proteinuria with C3 glomerulonephritis

Billable
Chapter 14
Diseases of the genitourinary system
Section
N00-N08
Use when the record says
  • Isolated proteinuria with C3 glomerulopathy
Indexed under
  • Proteinuria › isolated › with glomerular lesion › C3 › glomerulonephritis
  • Proteinuria › isolated › with glomerular lesion › 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