Excludes1 pair
N11.0 vs N13.7-
N11.0 and N13.7 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 N13.7
reflux-associated pyelonephritis (N11.0)
N11.0
Nonobstructive reflux-associated chronic pyelonephritis
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N10-N16
Use when the record says
- Pyelonephritis (chronic) associated with (vesicoureteral) reflux
Indexed under
- Pyelonephritis › nonobstructive › with reflux (vesicoureteral)
- Pyelonephritis › chronic › nonobstructive › with reflux (vesicoureteral)
- Reflux › vesicoureteral › with › pyelonephritis (chronic)
- Nephritis, nephritic › tubulo-interstitial › chronic › nonobstructive › reflux-associated
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