Assign codes from category I12, Hypertensive chronic kidney disease, when both hypertension and a condition classifiable to category N18, Chronic kidney disease (CKD), are present. CKD should not be coded as hypertensive if the provider indicates the CKD is not related to the hypertension. The appropriate code from category N18 should be used as a secondary code with a code from category I12 to identify the stage of chronic kidney disease. See Section I.C.14. Chronic kidney disease. If a patient has hypertensive chronic kidney disease and acute renal failure, the acute renal failure should also be coded. Sequence according to the circumstances of the admission/encounter.
N18.5
Chronic kidney disease, stage 5
Billable FY2026 2025-10-01 → 2026-09-30
Exclusions 20 never code together
N17-N19block
Excludes2
- congenital renal failure (P96.0)P96.0
- drug- and heavy-metal-induced tubulo-interstitial and tubular conditions (N14.-)N14.-
- extrarenal uremia (R39.2)R39.2
- hemolytic-uremic syndrome (D59.3-)D59.3-
- hepatorenal syndrome (K76.7)K76.7
- postpartum hepatorenal syndrome (O90.41)O90.41
- posttraumatic renal failure (T79.5)T79.5
- prerenal uremia (R39.2)R39.2
- renal failure complicating abortion or ectopic or molar pregnancy (O00-O07, O08.4)O00-O07O08.4
- renal failure following labor and delivery (O90.41)O90.41
- renal failure postprocedural (N99.0)N99.0
N00-N99chapter
Excludes2
- certain conditions originating in the perinatal period (P04-P96)P04-P96
- certain infectious and parasitic diseases (A00-B99)A00-B99
- complications of pregnancy, childbirth and the puerperium (O00-O9A)O00-O9A
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)Q00-Q99
- endocrine, nutritional and metabolic diseases (E00-E88)E00-E88
- injury, poisoning and certain other consequences of external causes (S00-T88)S00-T88
- neoplasms (C00-D49)C00-D49
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)R00-R94
Excludes1 — never code together. The excluded condition and this one are mutually exclusive.
Excludes2 — not included here, but the patient may have both. Code both when documented.
Instructional notes 6
N18code
Code first
Official Guidelines 5 names this code
ICD-10-CM Official Guidelines for Coding and Reporting, quoted in full. Published by CMS and NCHS; in the public domain.
The codes in category I13, Hypertensive heart and chronic kidney disease, are combination codes that include hypertension, heart disease and chronic kidney disease. Assign codes from combination category I13, Hypertensive heart and chronic kidney disease, when there is hypertension with both heart and chronic kidney disease. If heart failure is present, assign an additional code from category I50 to identify the type of heart failure. The appropriate code from category N18, Chronic kidney disease, should be used as a secondary code with a code from category I13 to identify the stage of chronic kidney disease. See Section I.C.14. Chronic kidney disease. The Includes note at I13 specifies that the conditions included at I11 and I12 are included together in I13. If a patient has hypertension, heart disease and chronic kidney disease, then a code from I13 should be used, not codes from I11 or I12, For patients with both acute renal failure and chronic kidney disease, the acute renal failure should also be coded. Sequence according to the circumstances of the admission/encounter.
Patients who have undergone kidney transplant may still have some form of chronic kidney disease (CKD) because the kidney transplant may not fully restore kidney function. Therefore, the presence of CKD alone does not constitute a transplant complication. Assign the appropriate N18 code for the patient’s stage of CKD and code Z94.0, Kidney transplant status. If a transplant complication such as failure or rejection or other transplant complication is documented, see section I.C.19.g for information on coding complications of a kidney transplant. If the documentation is unclear as to whether the patient has a complication of the transplant, query the provider.
The ICD-10-CM classifies CKD based on severity. The severity of CKD is designated by stages 1-5. Stage 2, code N18.2, equates to mild CKD; stage 3, codes N18.30-N18.32, equate to moderate CKD; and stage 4, code N18.4, equates to severe CKD. Code N18.6, End stage renal disease (ESRD), is assigned when the provider has documented end- stage renal disease (ESRD). If both a stage of CKD and ESRD are documented, assign code N18.6 only.
Patients with CKD may also suffer from other serious conditions, most commonly diabetes mellitus and hypertension. The sequencing of the CKD code in relationship to codes for other contributing conditions is based on the conventions in the Tabular List. See I.C.9. Hypertensive chronic kidney disease. See I.C.19. Chronic kidney disease and kidney transplant complications.
Index entries leading here 1
Alongside this code 6 same parent — N18
Medications 1
MED-RT files conditions by MeSH, which carves the world differently from ICD-10. These are name matches on this code's description, offered as candidates — not as an assertion that they are this code.
Additional references
AHA Coding Clinic® Licence required
Official coding advice for this code. Published by the American Hospital Association. Not included in this installation.