Excludes1 pair
N18.5 vs N18.6
N18.5 and N18.6 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 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 (ESRD)
- Disease, diseased › renal › end-stage (failure)
- Failure, failed › renal › end stage (chronic)
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