N18.5

Billable

Chronic kidney disease, stage 5

HCC Category Mapping

V28HCC 326 — Chronic Kidney Disease, Stage 5/End Stage Renal Disease

0.451

V24HCC 136 — Chronic Kidney Disease, Stage 5

0.289

ESRDHCC 136 — Chronic Kidney Disease, Stage 5

0.000

RxHCCHCC 262 — Hypertensive Chronic Kidney Disease, Stage 5

0.000

What This Code Means

Stage 5 chronic kidney disease (end-stage renal disease) where kidney function is severely compromised with a GFR less than 15, requiring dialysis or kidney transplant.

Coding Tips

•Confirm GFR is less than 15 mL/min/1.73m² or that the patient is on dialysis or has received a kidney transplant
•Code dialysis status separately (Z99.2 for dependence on dialysis) and document transplant status if applicable; also code related complications

Clinical Significance

Stage 5 chronic kidney disease represents kidney failure (GFR <15) requiring renal replacement therapy or preparation for dialysis/transplant. This diagnosis indicates end-stage kidney disease with significant morbidity, mortality risk, and high healthcare resource utilization requiring specialized nephrology management.

Documentation Requirements

✓Chronic kidney disease stage 5 clearly documented
✓GFR less than 15 or patient on dialysis
✓Active renal replacement therapy or preparation documented
✓Management of stage 5 CKD complications
✓Nephrology management and treatment plan
✓Assessment for transplant candidacy if appropriate
✓Documentation of dialysis type and schedule if applicable

Excludes 1 — Do NOT code together

chronic kidney disease, stage 5 requiring chronic dialysis (N18.6)

Commonly Confused Codes

N18.4 — Chronic kidney disease, stage 4 (GFR 15-29, less severe)N18.6 — End stage renal disease (essentially equivalent but different terminology)Z99.2 — Dependence on renal dialysis (status code, not disease code)N19 — Unspecified kidney failure (when stage is not documented)

Code Hierarchy

└N18Chronic kidney disease (CKD)└N18.5Chronic kidney disease, stage 5

└N18.5Chronic kidney disease, stage 5