N18.5: Chronic kidney disease, stage 5
N18.5 is a billable, specific ICD-10-CM code for chronic kidney disease, stage 5. It is valid for submission on a claim.
Check N18.5 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- chronic kidney disease, stage 5 requiring chronic dialysis (N18.6)
Other codes that can never be billed with N18.5
Their own Excludes1 notes name this code, so the conflict is not listed above.
- N19Unspecified kidney failure
Risk adjustment
N18.5 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 326 Chronic Kidney Disease, Stage 50.815 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
N18.5 is named in 39 Medicare coverage policies: 39 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52996Billing and Coding: Routine Foot Care
- A55336Billing and Coding: Retroperitoneal Ultrasound
- A56232Billing and Coding: Foot Care
- A56416Billing and Coding: Assays for Vitamins and Metabolic Function
Alphabetic index entries that lead here
- Disease, diseased›kidney›chronic›stage 5
There’s a guided path to this code
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.