N13.5 vs N13.6
N13.5 and N13.6 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on N13.5
Crossing vessel and stricture of ureter without hydronephrosis with infection (N13.6)
N13.5
Crossing vessel and stricture of ureter without hydronephrosis
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N10-N16
Use when the record says
- Kinking and stricture of ureter without hydronephrosis
Indexed under
- Ormond's disease (with ureteral obstruction)
- Angulation › ureter
- Compression › ureter
- Constriction › ureter
- Contraction, contracture, contracted › ureterovesical orifice (s)
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 (with ureteral obstruction)
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