The ICD-10-CM code for End Stage Renal Disease is N18.6 (End stage renal disease), a billable code reported when a patient requires chronic dialysis or has documented end stage renal disease.
Primary codes
Billable
Billable
Extension
—
7th character
—
POA exempt
No
Inclusion terms
- Chronic kidney disease requiring chronic dialysis
Use additional code
- code to identify dialysis status (Z99.2)
Coding risks
- Missing a required companion or status code
Hierarchy
Code comparison
Compare key differences between related codes to select the most specific option.
Select the most specific code supported by the encounter documentation. More specific codes improve reimbursement accuracy and reduce audit risk.
Code ranges
Chronic kidney disease (CKD)
Chronic kidney disease staged by severity from stage 1 through end stage renal disease requiring dialysis or transplant.
Acute kidney failure and chronic kidney disease
Encompasses acute kidney failure, chronic kidney disease, and unspecified kidney failure across the spectrum of renal dysfunction.
Acute kidney failure
Sudden loss of kidney function classified by underlying pathology such as tubular necrosis or cortical necrosis.
Dependence on renal dialysis
Status code indicating a patient's ongoing dependence on hemodialysis or peritoneal dialysis for renal replacement therapy.
Complications of kidney transplant
Captures rejection, failure, infection, and other complications following kidney transplantation procedures.
Coding risks
Avoid these common coding issues when reporting End Stage Renal Disease.
Impact
Assigning N18.6 without explicit dialysis dependence may misrepresent the condition when stage 5 CKD (N18.5) is more accurate.
Mitigation
Consider querying the provider when dialysis status is absent rather than inferring from low eGFR or nephrology follow-up alone.
Related codes
Ancillary and co-coding
Codes commonly reported with the primary diagnosis on the same claim.
Z-code variants
Family history, personal history, or screening encounter codes related to this condition.
In pregnancy
Pregnancy-specific O-code adaptations used in place of the primary when the condition occurs during or complicates pregnancy.
Differential codes
Alternative or commonly confused codes to consider when documentation suggests a different condition than the primary diagnosis.
Frequently asked questions
When chronic dialysis dependence is documented, add Z99.2 alongside N18.6 to capture the ongoing renal replacement status.
References
Compiled from the following authoritative coding references. Last updated 2026-08-04.