Excludes1 pair
N08 vs N16
N08 and N16 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 N08
pyelonephritis in diseases classified elsewhere (N16)
N08
Glomerular disorders in diseases classified elsewhere
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N00-N08
Use when the record says
- Glomerulonephritis
- Nephritis
- Nephropathy
Indexed under
- Nephritis, nephritic › amyloid
- Nephropathy › sickle-cell
- Disorder › glomerular › amyloidosis
- Disorder › glomerular › cryoglobulinemia
- Disorder › glomerular › disseminated intravascular coagulation
N16
Renal tubulo-interstitial disorders in diseases classified elsewhere
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N10-N16
Use when the record says
- Pyelonephritis
- Tubulo-interstitial nephritis
Indexed under
- Disorder › tubulo-interstitial › brucellosis
- Disorder › tubulo-interstitial › glycogen storage disease
- Disorder › tubulo-interstitial › leukemia NEC
- Disorder › tubulo-interstitial › lymphoma NEC
- Disorder › tubulo-interstitial › mixed cryoglobulinemia
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