What is ICD-10 code N25.0?

N25.0 is the ICD-10-CM diagnosis code for Renal osteodystrophy. Bone disease that develops when kidneys fail to properly regulate calcium and phosphorus, leading to weak and brittle bones. It belongs to the ICD-10-CM chapter for diseases of the genitourinary system (n00-n99). N25.0 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. N25.0 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. N25.0 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. N25.0 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for N25.0?

N25.0 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither community model rewards N25.0 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's V28/V24 community RAF score in either version. It does, however, map under the Part D RxHCC model (Osteoporosis, Vertebral and Pathological Fractures), which affects the ESRD and/or Part D (RxHCC) risk scores. Coders should check whether provider documentation supports a more specific child code that does map to a community payment HCC.

What should coders know when reporting N25.0?

This is a chronic complication of kidney disease; verify stage of CKD for complete coding May require additional codes for specific bone manifestations if documented

2026 ICD-10-CM N25.0: Renal osteodystrophy

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupN25.0Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the genitourinary system (N00-N99) / Other disorders of kidney and ureter (N25-N29)

N25.0

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Renal osteodystrophy

Bone disease that develops when kidneys fail to properly regulate calcium and phosphorus, leading to weak and brittle bones.

Buddy Insight

Renal osteodystrophy represents bone disease secondary to chronic kidney disease, indicating CKD-mineral bone disorder requiring specialized management.

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

Mapped

HCC 87

Osteoporosis, Vertebral and P...

RAF 0.055

Code Book Path

Official

N25Disorders resulting from impaired renal tubular function

N25.0Renal osteodystrophy

Inclusion Terms

Official

Azotemic osteodystrophy
Phosphate-losing tubular disorders
Renal rickets
Renal short stature

Excludes 2

Official

metabolic disorders classifiable to E70-E88

Related Child Codes

Official

N25.1Nephrogenic diabetes insipidus

N25.8Other disorders resulting from impaired renal tubular function

N25.9Disorder resulting from impaired renal tubular function, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for N25.0 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for N25.0 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for N25.0 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for N25.0 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for N25.0 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Renal osteodystrophy clearly documented

Underlying chronic kidney disease documented and coded

Evidence of bone disease related to kidney dysfunction

Laboratory values showing calcium, phosphorus, or PTH abnormalities

MEAT Support

HCC Buddy guidance

Renal osteodystrophy clearly documented

Underlying chronic kidney disease documented and coded

Evidence of bone disease related to kidney dysfunction

Laboratory values showing calcium, phosphorus, or PTH abnormalities

Audit Caution

HCC Buddy guidance

Not coding the underlying chronic kidney disease separately

Confusing with primary bone diseases unrelated to kidney function

Using only metabolic disorder codes without capturing bone involvement

Failing to recognize this as a complication of CKD requiring specific coding

Common Mistakes

HCC Buddy guidance

M83.9 — Adult osteomalacia, unspecified (not specifically kidney-related)

E83.30 — Disorder of phosphorus metabolism, unspecified (metabolic, not bone)

N25.81 — Secondary hyperparathyroidism of renal origin (related but different)

M80.00 — Osteoporosis with current pathological fracture (primary bone disease)

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is N25.0 an HCC code?

N25.0 is not in the CMS-HCC V28 or V24 community payment model, but it does map to Osteoporosis, Vertebral and Pathological Fractures under the Part D RxHCC model.

Code: N25.0
Description: Renal osteodystrophy
HCC (V28): No CMS-HCC V28 mapping
RAF: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

RxHCCHCC 87, Osteoporosis, Vertebral and Pathological Fractures

0.055

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work N25.0 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for N25.0

For N25.0 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed N25.0 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

N25.0 is the ICD-10-CM diagnosis code for renal osteodystrophy. Bone disease that develops when kidneys fail to properly regulate calcium and phosphorus, leading to weak and brittle bones. N25.0 sits in the ICD-10-CM chapter for diseases of the genitourinary system (n00-n99), within the section covering other disorders of kidney and ureter (n25-n29).

N25.0 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 code does not map to a CMS-HCC V28 payment category. Capture depends on documentation that supports the diagnosis; verify the HCC assignment against the current CMS mapping for the applicable payment year. Coders reviewing N25.0 should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for N25.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This is a chronic complication of kidney disease; verify stage of CKD for complete coding
•May require additional codes for specific bone manifestations if documented

Clinical Significance

Renal osteodystrophy represents bone disease secondary to chronic kidney disease, indicating CKD-mineral bone disorder requiring specialized management. This condition reflects complex metabolic complications of kidney disease affecting calcium-phosphorus homeostasis and bone health, requiring ongoing monitoring and treatment.

Documentation Requirements

✓Renal osteodystrophy clearly documented
✓Underlying chronic kidney disease documented and coded
✓Evidence of bone disease related to kidney dysfunction
✓Laboratory values showing calcium, phosphorus, or PTH abnormalities
✓Imaging studies showing bone changes if applicable
✓Treatment plan for CKD-mineral bone disorder
✓Monitoring schedule for bone health parameters

Excludes 2, Not included here, may code separately

metabolic disorders classifiable to E70-E88

Commonly Confused Codes

•M83.9: Adult osteomalacia, unspecified (not specifically kidney-related)
•E83.30: Disorder of phosphorus metabolism, unspecified (metabolic, not bone)
•N25.81: Secondary hyperparathyroidism of renal origin (related but different)
•M80.00: Osteoporosis with current pathological fracture (primary bone disease)

Child Codes

N25.0Renal osteodystrophy

N25.1Nephrogenic diabetes insipidus

N25.8Other disorders resulting from impaired renal tubular function

N25.9Disorder resulting from impaired renal tubular function, unspecified

Code Hierarchy

└N25Disorders resulting from impaired renal tubular function └N25.0Renal osteodystrophy

└N25.0Renal osteodystrophy

N25.0 ICD-10-CM Code: Renal osteodystrophy

HCC Buddy Code Card

N25.0

Is N25.0 an HCC code?

HCC Category Mapping

MEAT Criteria for N25.0

Get the V28 RAF + MEAT cheat sheet

What This Code Means

Coding Tips

Clinical Significance

Documentation Requirements

Excludes 2, Not included here, may code separately

Commonly Confused Codes

Child Codes

Code Hierarchy

Work N25.0 in HCC Buddy