Excludes1 pair
N19 vs N28.9
N19 and N28.9 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 N19
renal insufficiency (acute) (N28.9)
N19
Unspecified kidney failure
BillableUnspecified
- Chapter 14
- Diseases of the genitourinary system
- Section
- N17-N19
Use when the record says
- Uremia NOS
Indexed under
- Uremia, uremic
- Azotemia › meaning uremia
- Failure, failed › kidney
- Failure, failed › renal
- Stasis › kidney
N28.9
Disorder of kidney and ureter, unspecified
BillableUnspecified
- Chapter 14
- Diseases of the genitourinary system
- Section
- N25-N29
Use when the record says
- Nephropathy NOS
- Renal disease (acute) NOS
- Renal insufficiency (acute)
Indexed under
- Inefficiency, kidney
- Nephropathy
- Shutdown, renal
- Block, blocked › kidney
- Cachexia › renal
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