N23 vs R10
N23 and R10 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 R10
renal colic (N23)
N23
Unspecified renal colic
BillableUnspecified
- Chapter 14
- Diseases of the genitourinary system
- Section
- N20-N23
Indexed under
- Nephralgia
- Ureteralgia
- Colic › kidney (bilious) (infantile) (intestinal) (recurrent) (spasmodic)
- Colic › nephritic (bilious) (infantile) (intestinal) (recurrent) (spasmodic)
- Colic › renal (bilious) (infantile) (intestinal) (recurrent) (spasmodic)
R10
Abdominal and pelvic pain
Not billable
- Chapter 18
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
- Section
- R10-R19
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
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