Excludes1 pair
N13.1 vs N13.6
N13.1 and N13.6 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 N13.1
Hydronephrosis with ureteral stricture with infection (N13.6)
N13.1
Hydronephrosis with ureteral stricture, not elsewhere classified
BillableUnspecified
- Chapter 14
- Diseases of the genitourinary system
- Section
- N10-N16
Indexed under
- Hydronephrosis NEC › with › ureteral stricture NEC
- Hydronephrosis NEC › with › obstruction › ureteral NEC
- Kink, kinking › ureter › with › hydronephrosis
- Obstruction, obstructed, obstructive › ureter NEC › with › hydronephrosis
- Stricture › ureter › with › hydronephrosis
N13.6
Pyonephrosis
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N10-N16
Use when the record says
- Conditions in N13.0-N13.5 with infection
- Obstructive uropathy with infection
Indexed under
- Hydropyonephrosis
- Pyohydronephrosis
- Pyonephrosis
- Hydroureter › with infection
- Ormond's disease › with infection
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