2022 ICD-10-CM Diagnosis Code N18.4: Chronic Kidney Disease ...

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2026

  1. ICD-10-CM Codes
    2. ›
  2. N00-N99
    3. ›
  3. N17-N19
    4. ›
  4. N18-
    5. ›
  5. 2026 ICD-10-CM Diagnosis Code N18.4
2026 ICD-10-CM Diagnosis Code N18.4

Chronic kidney disease, stage 4 (severe)

    2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 Billable/Specific Code
  • N18.4 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • The 2026 edition of ICD-10-CM N18.4 became effective on October 1, 2025.
  • This is the American ICD-10-CM version of N18.4 - other international versions of ICD-10 N18.4 may differ.
The following code(s) above N18.4 contain annotation back-referencesAnnotation Back-ReferencesIn this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to N18.4:
  • N00-N99 2026 ICD-10-CM Range N00-N99

    Diseases of the genitourinary systemType 2 Excludes
    • certain conditions originating in the perinatal period (P04-P96)
    • certain infectious and parasitic diseases (A00-B99)
    • complications of pregnancy, childbirth and the puerperium (O00-O9A)
    • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
    • endocrine, nutritional and metabolic diseases (E00-E88)
    • injury, poisoning and certain other consequences of external causes (S00-T88)
    • neoplasms (C00-D49)
    • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
    Diseases of the genitourinary system

  • N17-N19 2026 ICD-10-CM Range N17-N19

    Acute kidney failure and chronic kidney diseaseType 2 Excludes
    • congenital renal failure (P96.0)
    • drug- and heavy-metal-induced tubulo-interstitial and tubular conditions (N14.-)
    • extrarenal uremia (R39.2)
    • hemolytic-uremic syndrome (D59.3-)
    • hepatorenal syndrome (K76.7)
    • postpartum hepatorenal syndrome (O90.41)
    • posttraumatic renal failure (T79.5)
    • prerenal uremia (R39.2)
    • renal failure complicating abortion or ectopic or molar pregnancy (O00-O07, O08.4)
    • renal failure following labor and delivery (O90.41)
    • renal failure postprocedural (N99.0)
    Acute kidney failure and chronic kidney disease

  • N18 ICD-10-CM Diagnosis Code N18

    Chronic kidney disease (CKD)

      2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 Non-Billable/Non-Specific Code
    Code First
    • any associated:
    • diabetic chronic kidney disease (E08.22, E09.22, E10.22, E11.22, E13.22)
    • hypertensive chronic kidney disease (I12.-, I13.-)
    Use Additional
    • code, if applicable, to identify:
    • associated cachexia (E88.A)
    • kidney transplant status (Z94.0)
    Chronic kidney disease (CKD)
Approximate Synonyms
  • Anemia co-occurrent and due to chronic kidney disease stage 4
  • Anemia in chronic kidney disease stage 4
  • Benign htn heart and ckd, 4 (gfr15-29)
  • Benign htn heart and ckd, 4 (gfr15-29), w chf
  • Benign hypertensive heart and chronic renal disease stage 4
  • Benign hypertensive heart and chronic renal disease stage 4 with congestive heart failure
  • Benign hypertensive heart disease and chronic renal disease stage 4
  • Chronic kidney disease stage 4
  • Chronic kidney disease stage 4 associated with type 2 diabetes mellitus
  • Chronic kidney disease stage 4 due to benign hypertension
  • Chronic kidney disease stage 4 due to drug induced diabetes
  • Chronic kidney disease stage 4 due to hypertension
  • Chronic kidney disease stage 4 due to secondary diabetes
  • Chronic kidney disease stage 4 due to type 1 diabetes mellitus
  • Chronic kidney disease stage 4 due to type 2 diabetes mellitus
  • Chronic kidney disease, severe
  • Diabetes type 1, severe chronic kidney disease
  • Diabetes type 2 with severe kidney disease
  • Diabetes type 2, severe chronic kidney disease
  • Drug induced diabetes, severe chronic kidney disease
  • Hypertension in chronic kidney disease stage 4 due to type 2 diabetes mellitus
  • Hypertensive chronic kidney disease, severe
  • Hypertensive heart and chronic kidney disease stage 4
  • Hypertensive heart and chronic kidney disease stage 4 with congestive heart failure
  • Hypertensive kidney and heart disease
  • Hypertensive, severe chronic kidney disease
  • Malignant htn heart and ckd, (gfr15-29)
  • Malignant hypertensive chronic kidney disease stage 4
  • Malignant hypertensive heart and chronic kidney disease stage 4
  • Secondary diabetes with chronic kidney disease
  • Severe chronic kidney failure with hypertension
ICD-10-CM N18.4 is grouped within Diagnostic Related Group(s) (MS-DRG v43.0):
  • 008 Simultaneous pancreas and kidney transplant
  • 019 Simultaneous pancreas and kidney transplant with hemodialysis
  • 682 Renal failure with mcc
  • 683 Renal failure with cc
  • 684 Renal failure without cc/mcc

Convert N18.4 to ICD-9-CM

Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change
  • 2021 (effective 10/1/2020): No change
  • 2022 (effective 10/1/2021): No change
  • 2023 (effective 10/1/2022): No change
  • 2024 (effective 10/1/2023): No change
  • 2025 (effective 10/1/2024): No change
  • 2026 (effective 10/1/2025): No change
Code annotations containing back-references to N18.4:
  • Use Additional: I12.9, I13.10 ICD-10-CM Diagnosis Code I12.9

    Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease

      2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 Billable/Specific Code
    Applicable To
    • Hypertensive chronic kidney disease NOS
    • Hypertensive renal disease NOS
    Use Additional
    • code to identify the stage of chronic kidney disease (N18.1-N18.4, N18.9)
    ICD-10-CM Diagnosis Code I13.10

    Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease

      2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 Billable/Specific Code
    Applicable To
    • Hypertensive heart disease and hypertensive chronic kidney disease NOS
    Use Additional
    • code to identify the stage of chronic kidney disease (N18.1-N18.4, N18.9)

Diagnosis Index entries containing back-references to N18.4:

  • Disease, diseased - see also Syndrome
    • kidney (functional) (pelvis) N28.9ICD-10-CM Diagnosis Code N28.9

      Disorder of kidney and ureter, unspecified

        2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 Billable/Specific Code
      Applicable To
      • Nephropathy NOS
      • Renal disease (acute) NOS
      • Renal insufficiency (acute)
      Type 1 Excludes
      • chronic renal insufficiency (N18.9)
      • unspecified nephritic syndrome (N05.-)
      • chronic N18.9ICD-10-CM Diagnosis Code N18.9

        Chronic kidney disease, unspecified

          2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 Billable/Specific Code
        Applicable To
        • Chronic renal disease
        • Chronic renal failure NOS
        • Chronic renal insufficiency
        • Chronic uremia NOS
        • Diffuse sclerosing glomerulonephritis NOS
        • stage 4 N18.4 (severe)

ICD-10-CM Codes Adjacent To N18.4 N17.2 Acute kidney failure with medullary necrosis N17.8 Other acute kidney failure N17.9 Acute kidney failure, unspecified N18 Chronic kidney disease (CKD) N18.1 Chronic kidney disease, stage 1 N18.2 Chronic kidney disease, stage 2 (mild) N18.3 Chronic kidney disease, stage 3 (moderate) N18.30 Chronic kidney disease, stage 3 unspecified N18.31 Chronic kidney disease, stage 3a N18.32 Chronic kidney disease, stage 3b N18.4 Chronic kidney disease, stage 4 (severe) N18.5 Chronic kidney disease, stage 5 N18.6 End stage renal disease N18.9 Chronic kidney disease, unspecified N19 Unspecified kidney failure N20 Calculus of kidney and ureter N20.0 Calculus of kidney N20.1 Calculus of ureter N20.2 Calculus of kidney with calculus of ureter N20.9 Urinary calculus, unspecified N21 Calculus of lower urinary tract

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

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