N18.6

Billable

End stage renal disease

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 261 — End Stage Renal Disease and Dialysis

0.000

What This Code Means

End stage renal disease is the most severe form of chronic kidney disease where the kidneys have lost nearly all their ability to filter waste from the blood, requiring dialysis or transplantation.

Coding Tips

•Always specify the stage of CKD; N18.6 is specifically for stage 5 (ESRD)
•Document whether the patient is on dialysis or has received a transplant, as this affects treatment coding

Clinical Significance

End stage renal disease represents complete kidney failure requiring dialysis or transplantation for survival, indicating the most severe form of chronic kidney disease. This diagnosis carries significant morbidity, mortality, and healthcare resource utilization requiring comprehensive multidisciplinary management.

Documentation Requirements

✓End stage renal disease clearly documented
✓Evidence of complete or near-complete kidney failure
✓Current renal replacement therapy (dialysis or transplant) documented
✓Management of ESRD-related complications
✓Multidisciplinary care team involvement
✓Assessment of transplant status or candidacy
✓Documentation of dialysis adequacy and complications if applicable

Use Additional Code

code to identify dialysis status (Z99.2)

Commonly Confused Codes

N18.5 — Chronic kidney disease, stage 5 (essentially equivalent condition)Z99.2 — Dependence on renal dialysis (status code, not disease code)Z94.0 — Kidney transplant status (status code for post-transplant patients)N19 — Unspecified kidney failure (when ESRD is clearly established)

Code Hierarchy

└N18Chronic kidney disease (CKD)└N18.6End stage renal disease

└N18.6End stage renal disease