Excludes1 pair
N13.3- vs N13.6
N13.3 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 N13.3
hydronephrosis with infection (N13.6)
N13.3
Other and unspecified hydronephrosis
Not billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N10-N16
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