October 1 update. Our PDGM and ICD-10 tools now use the FY2027 code set: 190 codes added, 30 deleted, and no existing code changed clinical group.

See what changed

ICD-10 · PDGM grouping

N18 Chronic kidney disease (CKD)

All 9 codes in the N18 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.

ICD-10-CM FY2027 · CMS grouper v07.2.26

Codes in family

9

Can lead a claim

6

Cannot lead a claim

3

What CMS assigns to N18

6 of the 9 codes group to MMTA - Gastrointestinal tract and Genitourinary system; 3 are assigned no clinical group. 8 of the 9 count toward the Chronic Kidney Disease and End Stage Renal Disease comorbidity subgroup; 1 is assigned none. 6 of the 9 can lead a claim. CMS attaches a code-first note to all 9.

  • Chronic Kidney Disease and End Stage Renal Disease: counts toward the high comorbidity tier only in an interaction pair.

Code first

CMS grouper convention 137, on all 9 codes. Code first:

  • any associated:
  • diabetic chronic kidney disease (E08.22, E09.22, E10.22, E11.22, E13.22)
  • hypertensive chronic kidney disease (I12.-, I13.-)

Every code in N18

Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.

CodeDescriptionPrimary positionClinical groupComorbidity subgroup
N18.1Chronic kidney disease, stage 1Can lead a claim, code first appliesJChronic Kidney Disease and End Stage Renal Disease
N18.2Chronic kidney disease, stage 2 (mild)Can lead a claim, code first appliesJChronic Kidney Disease and End Stage Renal Disease
N18.3 Chronic kidney disease, stage 3 (moderate)
N18.30Chronic kidney disease, stage 3 unspecifiedCan lead a claim, code first appliesJChronic Kidney Disease and End Stage Renal Disease
N18.31Chronic kidney disease, stage 3aCan lead a claim, code first appliesJChronic Kidney Disease and End Stage Renal Disease
N18.32Chronic kidney disease, stage 3bCan lead a claim, code first appliesJChronic Kidney Disease and End Stage Renal Disease
N18.4Chronic kidney disease, stage 4 (severe)Can lead a claim, code first appliesJChronic Kidney Disease and End Stage Renal Disease
N18.5Chronic kidney disease, stage 5Cannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneChronic Kidney Disease and End Stage Renal Disease
N18.6End stage renal diseaseCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneChronic Kidney Disease and End Stage Renal Disease
N18.9Chronic kidney disease, unspecifiedCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone

Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.

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