N18.6 End stage renal disease

Billable ICD-10-CM code, FY2026. Acts as a Major Complication or Comorbidity (MCC) as a secondary diagnosis.

Applicable to

• Chronic kidney disease requiring chronic dialysis

Use additional code

• code to identify dialysis status (Z99.2)

Applies from N18 Chronic kidney disease (CKD)

Code first

• any associated:
• diabetic chronic kidney disease (E08.22, E09.22, E10.22, E11.22, E13.22)
• hypertensive chronic kidney disease (I12.-, I13.-)

Use additional code

• code, if applicable, to identify:
• associated cachexia (E88.A)
• kidney transplant status (Z94.0)

Risk adjustment (HCC)

• CMS-HCC V28: HCC 326 — Chronic Kidney Disease, Stage 5
• CMS-HCC V22: HCC 136 — Chronic Kidney Disease, Stage 5
• RxHCC V08: HCC 261 — Dialysis Status, Including End Stage Renal Disease
• ESRD V24: HCC 136

MS-DRG index

Defines the logic of DRG(s) 008 in MDC PRE.

Approximate ICD-9-CM (GEMs)

• 585.6 End stage renal disease

Code annotations containing back-references to N18.6

Back-references to N18.6

• Use Additional: E08.22 Diabetes mellitus due to underlying condition with diabetic chronic kidney disease ("code to identify stage of chronic kidney disease (N18.1-N18.6)")
• Use Additional: E09.22 Drug or chemical induced diabetes mellitus with diabetic chronic kidney disease ("code to identify stage of chronic kidney disease (N18.1-N18.6)")
• Use Additional: E10.22 Type 1 diabetes mellitus with diabetic chronic kidney disease ("code to identify stage of chronic kidney disease (N18.1-N18.6)")
• Use Additional: E11.22 Type 2 diabetes mellitus with diabetic chronic kidney disease ("code to identify stage of chronic kidney disease (N18.1-N18.6)")
• Use Additional: E13.22 Other specified diabetes mellitus with diabetic chronic kidney disease ("code to identify stage of chronic kidney disease (N18.1-N18.6)")
• Use Additional: I12.0 Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease ("code to identify the stage of chronic kidney disease (N18.5, N18.6)")
• Use Additional: I13.11 Hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic kidney disease, or end stage renal disease ("code to identify the stage of chronic kidney disease (N18.5, N18.6)")
• Use Additional: I13.2 Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease ("code to identify the stage of chronic kidney disease (N18.5, N18.6)")
• Type 1 Excludes: N18.5 Chronic kidney disease, stage 5 ("chronic kidney disease, stage 5 requiring chronic dialysis (N18.6)")
• Use Additional: Q87.81 Alport syndrome ("code to identify stage of chronic kidney disease (N18.1-N18.6)")
• Code Also: Z49 Encounter for care involving renal dialysis ("associated end stage renal disease (N18.6)")

Back-references to N18

• Code Also: D59.3 Hemolytic-uremic syndrome ("chronic kidney disease (N18.-)")
• Code First: D63.1 Anemia in chronic kidney disease ("underlying chronic kidney disease (CKD) (N18.-)")
• Code Also: E20.810 Autosomal dominant hypocalcemia ("chronic kidney disease (N18.-)")
• Code First: I5A Non-ischemic myocardial injury (non-traumatic) ("chronic kidney disease (CKD) (N18.-)")
• Use Additional: I75.81 Atheroembolism of kidney ("code for any associated acute kidney failure and chronic kidney disease (N17.-, N18.-)")
• Type 1 Excludes: N19 Unspecified kidney failure ("chronic kidney disease (N18.-)")

Diagnosis Index entries for N18.6

• Disease, diseased › end stage renal (ESRD)
• Disease, diseased › renal (functional) (pelvis) › end-stage (failure)
• Failure, failed › renal › end stage (chronic)

Nearby codes

• N18.30 Chronic kidney disease, stage 3 unspecified
• N18.31 Chronic kidney disease, stage 3a
• N18.32 Chronic kidney disease, stage 3b
• N18.4 Chronic kidney disease, stage 4 (severe)
• N18.5 Chronic kidney disease, stage 5
• N18.6 End stage renal disease (this code)
• N18.9 Chronic kidney disease, unspecified