N28.0 vs Q27.1
N28.0 and Q27.1 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 N28.0
congenital stenosis of renal artery (Q27.1)
N28.0
Ischemia and infarction of kidney
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N25-N29
Use when the record says
- Renal artery embolism
- Renal artery obstruction
- Renal artery occlusion
- Renal artery thrombosis
- Renal infarct
Indexed under
- Crisis › renal
- Embolism › kidney (multiple) (paradoxical)
- Embolism › renal (multiple) (paradoxical)
- Infarct, infarction › brewer's
- Infarct, infarction › kidney
Q27.1
Congenital renal artery stenosis
Billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q20-Q28
Indexed under
- Stenosis, stenotic › renal artery › congenital (cicatricial)
- Stricture › renal artery › congenital
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