2026 ICD-10-CM Diagnosis Code N18.5Chronic kidney disease, stage 5
ICD-10-CM Codes›N00–N99›N17-N19›CKD
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 326
- Chronic Condition
N18.5 is a billable ICD-10-CM diagnosis code for chronic kidney disease, stage 5. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 8, 19, 673 through 675, 682 through 684. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 153 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Chronic kidney disease.
For Medicare Advantage risk adjustment, N18.5 maps to CMS-HCC Category 326 (Chronic Kidney Disease, Stage 5) under the V28 model, adding a risk factor of about 0.815 for a community, non-dual, aged beneficiary in payment year 2026.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
N18.5 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2026.
Source: CMS Payment Year 2026 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Anemia in chronic kidney disease
- Anemia in chronic kidney disease stage 5
- Benign hypertensive heart disease
- Benign hypertensive heart disease and chronic renal disease stage 5
- Chronic kidney disease due to benign hypertension
- Chronic kidney disease stage 5
- Chronic kidney disease stage 5 due to benign hypertension
- Chronic kidney disease stage 5 due to drug induced diabetes mellitus
- Chronic kidney disease stage 5 due to hypertension
- Chronic kidney disease stage 5 due to type 1 diabetes mellitus
- Chronic kidney disease stage 5 due to type 2 diabetes mellitus
- Chronic kidney disease stage 5 on dialysis
- Chronic kidney disease stage 5 with transplant
- Disorder of kidney due to drug induced diabetes mellitus
- Hypertension in chronic kidney disease due to type 1 diabetes mellitus
- Hypertension in chronic kidney disease due to type 2 diabetes mellitus
- Hypertension in chronic kidney disease stage 5 due to type 1 diabetes mellitus
- Hypertension in chronic kidney disease stage 5 due to type 2 diabetes mellitus
- Hypertensive heart AND chronic kidney disease stage 5
- Inflammation of retina due to chronic kidney disease stage 5
- Malignant hypertensive chronic kidney disease
- Malignant hypertensive chronic kidney disease stage 5
- Malignant hypertensive renal disease
- Nephropathy due to secondary diabetes mellitus
- Renal retinopathy
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Type 1 Excludes
- chronic kidney disease, stage 5 requiring chronic dialysis N18.6
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Disease, diseased See Also: Syndrome;
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Kidney Failure
Healthy kidneys clean your blood by removing excess fluid, minerals, and wastes. They also make hormones that keep your bones strong and your blood healthy. But if the kidneys are damaged, they don't work properly. Harmful wastes can build up in your body. Your blood pressure may rise.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert N18.5 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About N18.5Overview
What is the ICD-10 code for chronic kidney disease, stage 5?
The ICD-10-CM code for chronic kidney disease, stage 5 is N18.5 (sometimes written as N185). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is N18.5 (Chronic kidney disease (CKD)) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report chronic kidney disease, stage 5 on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does N18.5 group to?
When chronic kidney disease, stage 5 is the principal diagnosis on an inpatient stay, it groups to MS-DRG 8, 19, 673, 674, 675, 682, 683, 684, with relative weights from 0.6003 to 6.6272 depending on complications. Higher weights mean higher Medicare reimbursement.
Is N18.5 a CC or MCC?
CMS lists N18.5 as a CC (complication or comorbidity) for FY 2026. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 153 closely related codes in its exclusion list.
What is the ICD-9 equivalent of N18.5?
Under the General Equivalence Mappings, chronic kidney disease, stage 5 converts to ICD-9-CM 585.5 (chron kidney dis stage V). The mapping is a direct match.
What HCC is N18.5?
N18.5 (chronic kidney disease, stage 5) maps to CMS-HCC Category 326 (Chronic Kidney Disease, Stage 5), commonly written as HCC 326, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It mapped to HCC 136 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 262.
Does N18.5 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, N18.5 adds a risk adjustment factor of about 0.815 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.815 to 1.050 depending on the payment segment). HCC 326 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 326 category page.
