N13.6 vs N39.0
N13.6 and N39.0 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 N39.0
pyonephrosis (N13.6)
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)
N39.0
Urinary tract infection, site not specified
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N30-N39
Indexed under
- Infection, infected, infective › urinary (opportunistic)
- Urine › pus in
- Pus › in › urine
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