Excludes1 pair

N11.1 vs N13-

N11.1 and N13 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 N11.1
obstructive uropathy (N13.-)
N11.1

Chronic obstructive pyelonephritis

Billable
Chapter 14
Diseases of the genitourinary system
Section
N10-N16
Use when the record says
  • Pyelonephritis (chronic) associated with anomaly of pelviureteric junction
  • Pyelonephritis (chronic) associated with anomaly of pyeloureteric junction
  • Pyelonephritis (chronic) associated with crossing of vessel
  • Pyelonephritis (chronic) associated with kinking of ureter
  • Pyelonephritis (chronic) associated with obstruction of ureter
  • Pyelonephritis (chronic) associated with stricture of pelviureteric junction
  • Pyelonephritis (chronic) associated with stricture of ureter
Indexed under
  • Pyelonephrosis (obstructive)
  • Obstruction, obstructed, obstructive › pyelonephritis (chronic)
  • Pyelonephritis › chronic › associated with ureteral obstruction or stricture
  • Pyelonephritis › chronic › obstructive
  • Pyelonephritis › in › obstruction
N13

Obstructive and reflux uropathy

Not billable
Chapter 14
Diseases of the genitourinary system
Section
N10-N16

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