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N19

Billable

Unspecified kidney failure

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is N19 an HCC code?

No. N19 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

N19 is the ICD-10-CM diagnosis code for unspecified kidney failure. Unspecified kidney failure refers to loss of kidney function where the cause or type (acute vs. chronic) has not been specified in the medical record. N19 sits in the ICD-10-CM chapter for diseases of the genitourinary system (n00-n99), within the section covering acute kidney failure and chronic kidney disease (n17-n19).

N19 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

This is a non-specific code; attempt to determine if the failure is acute (N17) or chronic (N18) before using N19.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for N19 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • This is a non-specific code; attempt to determine if the failure is acute (N17) or chronic (N18) before using N19
  • Review lab values and clinical presentation to help differentiate the type of kidney failure

Excludes 1 — Do NOT code together

  • 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)

Code Hierarchy

N19Unspecified kidney failure
N19Unspecified kidney failure

More on N19

Referenced in blog posts

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