2020 ICD-10-CM Diagnosis Code N18.6

End stage renal disease

    2016 2017 2018 2019 2020 Billable/Specific Code
  • N18.6 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • The 2020 edition of ICD-10-CM N18.6 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of N18.6 - other international versions of ICD-10 N18.6 may differ.
Applicable To
  • Chronic kidney disease requiring chronic dialysis
Use Additional
Use Additional Help
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
  • code to identify dialysis status (
    ICD-10-CM Diagnosis Code Z99.2

    Dependence on renal dialysis

      2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
    Applicable To
    • Hemodialysis status
    • Peritoneal dialysis status
    • Presence of arteriovenous shunt for dialysis
    • Renal dialysis status NOS
    Type 1 Excludes
    • encounter for fitting and adjustment of dialysis catheter (Z49.0-)
    Type 2 Excludes
    • noncompliance with renal dialysis (Z91.15)
    Z99.2
    )
The following code(s) above N18.6 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to N18.6:
  • N00-N99
    2020 ICD-10-CM Range N00-N99

    Diseases of the genitourinary system

    Type 2 Excludes
    • certain conditions originating in the perinatal period (P04-P96)
    • certain infectious and parasitic diseases (A00-B99)
    • complications of pregnancy, childbirth and the puerperium (O00-O9A)
    • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
    • endocrine, nutritional and metabolic diseases (E00-E88)
    • injury, poisoning and certain other consequences of external causes (S00-T88)
    • neoplasms (C00-D49)
    • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
    Diseases of the genitourinary system
  • N17-N19
    2020 ICD-10-CM Range N17-N19

    Acute kidney failure and chronic kidney disease

    Type 2 Excludes
    • congenital renal failure (P96.0)
    • drug- and heavy-metal-induced tubulo-interstitial and tubular conditions (N14.-)
    • extrarenal uremia (R39.2)
    • hemolytic-uremic syndrome (D59.3)
    • hepatorenal syndrome (K76.7)
    • postpartum hepatorenal syndrome (O90.4)
    • posttraumatic renal failure (T79.5)
    • prerenal uremia (R39.2)
    • renal failure complicating abortion or ectopic or molar pregnancy (O00-O07, O08.4)
    • renal failure following labor and delivery (O90.4)
    • renal failure postprocedural (N99.0)
    Acute kidney failure and chronic kidney disease
  • N18
    ICD-10-CM Diagnosis Code N18

    Chronic kidney disease (CKD)

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Code First
    Use Additional
    • code to identify kidney transplant status, if applicable, (Z94.0)
    Chronic kidney disease (CKD)
Approximate Synonyms
  • Anemia due to end stage renal disease
  • Anemia in end stage renal disease
  • Anemia, end stage renal disease
  • Benign htn heart and ckd, esrd, w chf
  • Benign hypertensive heart and end stage renal disease
  • Benign hypertensive heart and end stage renal disease with congestive heart failure
  • Chronic kidney disease
  • Chronic kidney disease due to type 2 diabetes mellitus with hyperparathyroidism due to end stage renal disease on dialysis
  • Chronic kidney disease on hemodialysis
  • Chronic kidney disease with end stage renal disease on dialysis due to drug induced diabetes mellitus
  • Chronic kidney disease with end stage renal disease on dialysis due to secondary diabetes mellitus
  • Chronic kidney disease with end stage renal disease on dialysis due to type 1 diabetes mellitus
  • Chronic kidney disease with end stage renal disease on dialysis due to type 2 diabetes mellitus
  • Chronic kidney disease, esrd due to benign hypertension
  • Chronic kidney failure with hypertension
  • Dependence on continuous ambulatory peritoneal dialysis due to end stage renal disease
  • Dependence on continuous cyclic peritoneal dialysis due to end stage renal disease
  • Dependence on dialysis due to end stage renal disease
  • Dependence on hemodialysis due to end stage renal disease
  • Dependence on peritoneal dialysis due to end stage renal disease
  • Diabetes 1 with end stage renal disease on dialysis
  • Diabetes 2 with end stage renal disease on dialysis
  • Diabetes type 1 on dialysis
  • Diabetes type 2 on dialysis
  • Dm 2 w diabetic ckd, secondary hyperparathyroidism due to esrd, on dialysis
  • Drug induced diabetes chronic kidney disease, dialysis
  • End stage renal disease due to hypertension
  • End stage renal disease due to hypertension, on dialysis
  • End stage renal disease on dialysis
  • End stage renal disease on dialysis due to hypertension
  • End stage renal disease on dialysis due to type 2 diabetes mellitus
  • End stage renal disease on peritoneal dialysis
  • Esrd on continuous ambulatory peritoneal dialysis
  • Esrd on continuous cyclic peritoneal dialysis
  • Hyperparathyroidism due to end stage renal disease on dialysis
  • Hypertension concurrent and due to end stage renal disease on dialysis due to type 2 diabetes mellitus
  • Hypertension in chronic kidney disease with end stage renal disease on dialysis due to type 1 diabetes mellitus
  • Hypertension in chronic kidney disease with end stage renal disease on dialysis due to type 2 diabetes mellitus
  • Hypertensive chronic kidney disease on dialysis
  • Hypertensive chronic kidney disease with dialysis
  • Hypertensive chronic kidney disease, severe
  • Hypertensive heart and chronic kidney disease on dialysis
  • Hypertensive heart and chronic kidney disease on dialysis with congestive heart failure
  • Hypertensive heart and kidney disease
  • Hypertensive heart disease, kidney disease
  • Hypertensive kidney and heart disease, on dialysis
  • Malignant htn ckd w esrd on dialysis
  • Malignant hypertensive end stage renal disease
  • Malignant hypertensive end stage renal disease on dialysis
  • Malignant hypertensive heart and end stage renal disease with congestive heart failure
  • Secondary diabetes, chronic kidney disease on dialysis
  • Secondary hyperparathyroidism due to esrd, on dialysis
  • Severe chronic kidney failure with hypertension
  • Severe chronic kidney failure with hypertension (htn) on dialysis
Clinical Information
  • Chronic, irreversible renal failure.
  • Long-standing and persistent renal disease with glomerular filtration rate (gfr) less than 15 ml/min.
ICD-10-CM N18.6 is grouped within Diagnostic Related Group(s) (MS-DRG v37.0):
  • 008 Simultaneous pancreas and kidney transplant
  • 673 Other kidney and urinary tract procedures with mcc
  • 674 Other kidney and urinary tract procedures with cc
  • 675 Other kidney and urinary tract procedures without cc/mcc
  • 682 Renal failure with mcc
  • 683 Renal failure with cc
  • 684 Renal failure without cc/mcc

Convert N18.6 to ICD-9-CM

Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change
Code annotations containing back-references to N18.6:
  • Code Also: Z49
    ICD-10-CM Diagnosis Code Z49

    Encounter for care involving renal dialysis

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Code Also
    • associated end stage renal disease (N18.6)
  • Type 1 Excludes: N18.5
    ICD-10-CM Diagnosis Code N18.5

    Chronic kidney disease, stage 5

      2016 2017 2018 2019 2020 Billable/Specific Code
    Type 1 Excludes
    • chronic kidney disease, stage 5 requiring chronic dialysis (N18.6)
  • Use Additional: E08.22
    , E09.22
    , E10.22
    , E11.22
    , E13.22
    , I12.0
    , I13.11
    , Q87.81
    ICD-10-CM Diagnosis Code E08.22

    Diabetes mellitus due to underlying condition with diabetic chronic kidney disease

      2016 2017 2018 2019 2020 Billable/Specific Code Manifestation Code
    Use Additional
    • code to identify stage of chronic kidney disease (N18.1-N18.6)
    ICD-10-CM Diagnosis Code E09.22

    Drug or chemical induced diabetes mellitus with diabetic chronic kidney disease

      2016 2017 2018 2019 2020 Billable/Specific Code
    Use Additional
    • code to identify stage of chronic kidney disease (N18.1-N18.6)
    ICD-10-CM Diagnosis Code E10.22

    Type 1 diabetes mellitus with diabetic chronic kidney disease

      2016 2017 2018 2019 2020 Billable/Specific Code
    Use Additional
    • code to identify stage of chronic kidney disease (N18.1-N18.6)
    ICD-10-CM Diagnosis Code E11.22

    Type 2 diabetes mellitus with diabetic chronic kidney disease

      2016 2017 2018 2019 2020 Billable/Specific Code
    Use Additional
    • code to identify stage of chronic kidney disease (N18.1-N18.6)
    ICD-10-CM Diagnosis Code E13.22

    Other specified diabetes mellitus with diabetic chronic kidney disease

      2016 2017 2018 2019 2020 Billable/Specific Code
    Use Additional
    • code to identify stage of chronic kidney disease (N18.1-N18.6)
    ICD-10-CM Diagnosis Code I12.0

    Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease

      2016 2017 2018 2019 2020 Billable/Specific Code
    Use Additional
    • code to identify the stage of chronic kidney disease (N18.5, N18.6)
    ICD-10-CM Diagnosis Code I13.11

    Hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic kidney disease, or end stage renal disease

      2016 2017 2018 2019 2020 Billable/Specific Code
    Use Additional
    • code to identify the stage of chronic kidney disease (N18.5, N18.6)
    ICD-10-CM Diagnosis Code Q87.81

    Alport syndrome

      2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
    Use Additional
    • code to identify stage of chronic kidney disease (N18.1-N18.6)

Diagnosis Index entries containing back-references to N18.6:
  • Disease, diseased - see also Syndrome
    • end stage renal (ESRD) N18.6
    • renal (functional) (pelvis) N28.9
      - see also Disease, kidney
      ICD-10-CM Diagnosis Code N28.9

      Disorder of kidney and ureter, unspecified

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Nephropathy NOS
      • Renal disease (acute) NOS
      • Renal insufficiency (acute)
      Type 1 Excludes
      • chronic renal insufficiency (N18.9)
      • unspecified nephritic syndrome (N05.-)
  • Failure, failed
    • renal N19
      ICD-10-CM Diagnosis Code N19

      Unspecified kidney failure

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Uremia NOS
      Type 1 Excludes
      • acute kidney failure (N17.-)
      • chronic kidney disease (N18.-)
      • chronic uremia (N18.9)
      • extrarenal uremia (R39.2)
      • prerenal uremia (R39.2)
      • renal insufficiency (acute) (N28.9)
      • uremia of newborn (P96.0)

ICD-10-CM Codes Adjacent To N18.6
N17.1 Acute kidney failure with acute cortical necrosis
N17.2 Acute kidney failure with medullary necrosis
N17.8 Other acute kidney failure
N17.9 Acute kidney failure, unspecified
N18 Chronic kidney disease (CKD)
N18.1 Chronic kidney disease, stage 1
N18.2 Chronic kidney disease, stage 2 (mild)
N18.3 Chronic kidney disease, stage 3 (moderate)
N18.4 Chronic kidney disease, stage 4 (severe)
N18.5 Chronic kidney disease, stage 5
N18.6 End stage renal disease
N18.9 Chronic kidney disease, unspecified
N19 Unspecified kidney failure
N20 Calculus of kidney and ureter
N20.0 Calculus of kidney
N20.1 Calculus of ureter
N20.2 Calculus of kidney with calculus of ureter
N20.9 Urinary calculus, unspecified
N21 Calculus of lower urinary tract
N21.0 Calculus in bladder
N21.1 Calculus in urethra

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.