ICD10BillableValid for clinical use
ICD-10 Code N18.5: Chronic kidney disease, stage 5
Reviewed by HealthAssure Clinical TeamUpdated 26 May 2026
What is this code?
ICD-10 codes are diagnosis classification codes used in healthcare records, reporting, coding workflows, and billing support. This code sits within the broader ICD-10 area for Diseases of the genitourinary system (N00-N99).
📋Clinical overview
This ICD-10 code is commonly used when documentation describes chronic kidney disease or long-term loss of kidney function. The most accurate code depends on the documented CKD stage, whether end-stage kidney disease is present, and how clearly the record links kidney status to the active problem list.
When is it used?
- May be used when a clinician documents chronic kidney disease, stage 5 in a patient's medical record.
- May appear in hospital records, claims, referrals, and clinical documentation.
- This code can be used as a clinically usable diagnosis entry in standardized coding workflows.
What it does not mean
- A code alone does not explain severity, treatment plan, or outcome.
- A medical code should not be treated as a substitute for a doctor's diagnosis or advice.
🩺Clinical context
When commonly used
- Primary care, nephrology, inpatient, and chronic-disease documentation where reduced kidney function is part of ongoing management.
- Risk-adjustment, utilization-review, and care-continuity workflows where CKD stage affects medication review, monitoring, and longitudinal care planning.
Common workup
- Common related testing on this page includes Serum creatinine, Estimated glomerular filtration rate (eGFR), Urine albumin creatinine ratio.
- Related procedures or service context already linked on this page include Hemodialysis, Peritoneal dialysis, Dialysis access procedure.
Common management context
- CKD follow-up often includes kidney-function laboratory review, urine testing, blood-pressure management, medication reconciliation, and monitoring for disease progression.
- Documentation usually becomes more specific when the chart identifies CKD stage, dialysis status, transplant history, proteinuria, anemia, or mineral and bone complications.
- Specialist context already linked on this page includes Nephrologist, General Physician.
🔍Key distinctions
Important notes
- ICD-10 CKD coding is stage-sensitive, so documentation that clearly states stage 1 through stage 5 or end-stage renal disease usually determines the final code choice.
- CKD may coexist with diabetes, hypertension, anemia, or other chronic conditions, but separate linked diagnoses may still require their own more specific codes.
- Stage 5 CKD documentation reflects very advanced chronic kidney disease and should be distinguished from broader unspecified chronic kidney disease language.
Important exclusions
- chronic kidney disease, stage 5 requiring chronic dialysis (N18.6)
Related codes to consider
N18.1Chronic kidney disease, stage 1
Related chronic-kidney-disease ICD-10 code; documentation often becomes more specific when the chart identifies CKD stage, end-stage disease, or associated kidney-status detail.
N18.2Chronic kidney disease, stage 2 (mild)
Related chronic-kidney-disease ICD-10 code; documentation often becomes more specific when the chart identifies CKD stage, end-stage disease, or associated kidney-status detail.
N18.3Chronic kidney disease, stage 3 (moderate)
Related chronic-kidney-disease ICD-10 code; documentation often becomes more specific when the chart identifies CKD stage, end-stage disease, or associated kidney-status detail.
N18.4Chronic kidney disease, stage 4 (severe)
Related chronic-kidney-disease ICD-10 code; documentation often becomes more specific when the chart identifies CKD stage, end-stage disease, or associated kidney-status detail.
Code hierarchy
chapter
14Diseases of the genitourinary system (N00-N99)
block
N17-N19Acute kidney failure and chronic kidney disease
category
N18Chronic kidney disease (CKD)
currentN18
Official coding notes
Excludes1 (do not code together)
- chronic kidney disease, stage 5 requiring chronic dialysis (N18.6)
Where you may see this code
You may see this code in hospital records, discharge summaries, insurance claims, encounter documentation, referrals, or other healthcare billing and coding records.
Related specialists
NephrologistGeneral Physician
Related tests
Serum creatinine
Commonly reviewed in chronic kidney disease assessment.
Estimated glomerular filtration rate (eGFR)
Often used to assess kidney function stage and trend.
Urine albumin creatinine ratio
May help review protein leakage and kidney involvement.
Related procedures
Hemodialysis
May appear in advanced chronic kidney disease care pathways.
Peritoneal dialysis
May appear in advanced chronic kidney disease care pathways.
Dialysis access procedure
May be part of treatment planning when renal replacement therapy is needed.
Related codes
Sibling codes
Coverage-related procedures and services
CPT 82306high
VITAMIN D; 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED
Source: CMS coverage guidance
CPT 11720high
DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); 1 TO 5
Source: CMS coverage guidance
CPT 11721high
DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); 6 OR MORE
Source: CMS coverage guidance
HCPCS G0127high
TRIMMING OF DYSTROPHIC NAILS, ANY NUMBER
Source: CMS coverage guidance
CPT 11719high
TRIMMING OF NONDYSTROPHIC NAILS, ANY NUMBER
Source: CMS coverage guidance
CPT 82652high
VITAMIN D; 1, 25 DIHYDROXY, INCLUDES FRACTION(S), IF PERFORMED
Source: CMS coverage guidance
Mapped diagnoses and classifications
SNOMED_CT 194909006high
Acute pericarditis secondary to uremia
Source: SNOMED International ICD-10 map
SNOMED_CT 691411000119101high
Anemia in chronic kidney disease stage 5
Source: SNOMED International ICD-10 map
SNOMED_CT 707324008high
Anemia in end stage renal disease
Source: SNOMED International ICD-10 map
SNOMED_CT 433146000high
Chronic kidney disease stage 5
Source: SNOMED International ICD-10 map
SNOMED_CT 285011000119108high
Chronic kidney disease stage 5 due to benign hypertension
Source: SNOMED International ICD-10 map
SNOMED_CT 368461000119103high
Chronic kidney disease stage 5 due to drug induced diabetes mellitus
Source: SNOMED International ICD-10 map
Coding guidelines
Compatibility
Legacy and official ICD code match exactly.
Legacy codes
N18.5
Common synonyms
Chronic kidney disease, stage 5
Frequently asked questions
About this content
This page is prepared by HealthAssure's clinical team using official coding standards from ICD-10. AI tools assist with drafting explanations, which are then reviewed and verified by healthcare professionals for accuracy. This content is for informational purposes and does not replace professional medical advice. Meet our team.