N18.5 vs N18.6
N18.5 and N18.6 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 N18.5
chronic kidney disease, stage 5 requiring chronic dialysis (N18.6)
N18.5
Chronic kidney disease, stage 5
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N17-N19
Indexed under
- Disease, diseased › kidney › chronic › stage 5
N18.6
End stage renal disease
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N17-N19
Use when the record says
- Chronic kidney disease requiring chronic dialysis
Indexed under
- Disease, diseased › end stage renal
- Disease, diseased › renal › end-stage
- Failure, failed › renal › end stage
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