Is N11.1 a billable ICD-10-CM code?

Yes. N11.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does N11.1 sit in the tabular list?

Diseases of the genitourinary system (N00-N99), in the block Renal tubulo-interstitial diseases (N10-N16).

What cannot be coded together with N11.1?

N11.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

N11.1

N11.1 — Chronic obstructive pyelonephritis

Billable / specific codeICD-10-CM

N11.1 is a billable, specific ICD-10-CM code for chronic obstructive pyelonephritis. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

calculous pyelonephritis (N20.9)
obstructive uropathy (N13.-)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Pyelonephritis (chronic) associated with anomaly of pelviureteric junction
Pyelonephritis (chronic) associated with anomaly of pyeloureteric junction
Pyelonephritis (chronic) associated with crossing of vessel
Pyelonephritis (chronic) associated with kinking of ureter
Pyelonephritis (chronic) associated with obstruction of ureter
Pyelonephritis (chronic) associated with stricture of pelviureteric junction
Pyelonephritis (chronic) associated with stricture of ureter

Risk adjustment

N11.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

N11.1 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A55336Billing and Coding: Retroperitoneal Ultrasound
A56421Billing and Coding: CT of the Abdomen and Pelvis

How N11.1 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to N11.1.

Pyelonephrosis(obstructive)
Obstruction, obstructed, obstructive›pyelonephritis(chronic)
Pyelonephritis›chronic›associated with ureteral obstruction or stricture
Pyelonephritis›chronic›obstructive
Pyelonephritis›in›obstruction
Kink, kinking›ureter›with›pyelonephritis(chronic)
Nephritis, nephritic›tubulo-interstitial›chronic›obstructive
Obstruction, obstructed, obstructive›ureter NEC›with›pyelonephritis(chronic)
Stricture›ureter›with›pyelonephritis(chronic)

Related codes at this level

Codes that share N11. If N11.1 is not quite right, the correct code is usually one of these.

Questions about N11.1

Is N11.1 a billable ICD-10-CM code?: Yes. N11.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does N11.1 sit in the tabular list?: Diseases of the genitourinary system (N00-N99), in the block Renal tubulo-interstitial diseases (N10-N16).
What cannot be coded together with N11.1?: N11.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.