2026 ICD-10-CM Diagnosis Code N18.6End stage renal disease
ICD-10-CM Codes›N00–N99›N17-N19›CKD
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Risk Adjusts — HCC 326
- Chronic Condition
N18.6 is a billable ICD-10-CM diagnosis code for end stage renal disease. 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 major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of 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, N18.6 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
N18.6 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 end stage renal disease
- Anemia of renal disease
- Anemia secondary to renal failure
- Cardiorenal syndrome
- Chronic kidney disease due to benign hypertension
- Dependence on continuous ambulatory peritoneal dialysis
- Dependence on continuous ambulatory peritoneal dialysis due to end stage renal disease
- Dependence on dialysis due to end stage renal disease
- Dependence on energy-dependent medical equipment and/or device
- Dependence on hemodialysis
- Dependence on hemodialysis due to end stage renal disease
- Dependence on peritoneal dialysis
- Dependence on peritoneal dialysis due to end stage renal disease
- Dependence on renal dialysis
- Disorder of kidney due to drug induced diabetes mellitus
- End stage renal disease due to benign hypertension
- End stage renal disease due to hypertension
- End stage renal disease on dialysis due to drug induced diabetes mellitus
- End stage renal disease on dialysis due to hypertension
- End stage renal disease on dialysis due to type 1 diabetes mellitus
- End stage renal disease on dialysis due to type 2 diabetes mellitus
- End stage renal failure on dialysis
- End stage renal failure untreated by renal replacement therapy
- End stage renal failure with renal transplant
- End-stage renal disease
- Hyperparathyroidism due to end stage renal disease on dialysis
- Hyperparathyroidism due to renal insufficiency
- Hypertension concurrent and due to end stage renal disease on dialysis
- Hypertension concurrent and due to end stage renal disease on dialysis due to type 1 diabetes mellitus
- Hypertension concurrent and due to end stage renal disease on dialysis due to type 2 diabetes mellitus
- Hypertension in chronic kidney disease due to type 1 diabetes mellitus
- Hypertension in chronic kidney disease due to type 2 diabetes mellitus
- Hypertensive heart and renal disease with both heart failure and renal failure
- Hypertensive heart and renal disease with renal failure
- Hypertensive renal failure
- Malignant hypertensive chronic kidney disease
- Malignant hypertensive end stage renal disease
- Malignant hypertensive end stage renal disease on dialysis
- Malignant hypertensive renal disease
- Nephropathy due to secondary diabetes mellitus
- Postoperative renal impairment
- Secondary hyperparathyroidism
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Chronic kidney disease requiring chronic dialysis
Use Additional Code
- code to identify dialysis status Z99.2
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
The “use additional code” indicates that a secondary code could be used to further specify the patient’s condition. This note is not mandatory and is only used if enough information is available to assign an additional code.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Disease, diseased See Also: Syndrome;
end stage renal (ESRD) N18.6
renal (functional) (pelvis) See Also: Disease, kidney; N28.9
end-stage (failure) N18.6
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Cardiorenal Syndrome
a disorder of the heart and kidneys in which dysfunction of one of the organs induces dysfunction of the other organ.Secondary Hyperparathyroidism
overproduction of parathyroid hormone in response to influence external to the parathyroid glands.
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 N18.6 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About N18.6Overview
What is the ICD-10 code for end stage renal disease?
The ICD-10-CM code for end stage renal disease is N18.6 (sometimes written as N186). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is N18.6 (Chronic kidney disease (CKD)) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report end stage renal disease on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does N18.6 group to?
When end stage renal disease 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 N18.6 a CC or MCC?
CMS lists N18.6 as an MCC (major complication or comorbidity) for FY 2026. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of 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 N18.6?
Under the General Equivalence Mappings, end stage renal disease converts to ICD-9-CM 585.6 (end stage renal disease). The mapping is a direct match.
What HCC is N18.6?
N18.6 (end stage renal disease) 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 261.
Does N18.6 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, N18.6 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.
