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K76.7 vs N19

K76.7 (Hepatorenal syndrome) compared with N19 (Unspecified kidney failure), from the official CMS tabular data.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Summary

These codes can be reported together when both conditions are documented, because N19 lists K76.7 under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

The conditions named and chapter.K76.7 is “Hepatorenal syndrome”; N19 is “Unspecified kidney failure”. K76.7 sits in K00-K95 — Diseases of the Digestive System (K00-K95); N19 in N00-N99 — Diseases of the Genitourinary System (N00-N99).

Registry fact

Can these codes be reported together?

Yes, when both are documented.N19 lists K76.7 under Excludes2: “hepatorenal syndrome (K76.7)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes2 relationship?

Yes.N19’s tabular entry: “hepatorenal syndrome (K76.7)”. The note covers K76.7.

Official ruleGuide: Excludes1 vs Excludes2

Nothing found in 4 other checks; 1 check does not apply
Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. K76.7 carries 3 Excludes1 notes and N19 carries 7 Excludes1 notes covering other codes; the side-by-side table quotes them.

Official rule

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

No.Both are billable codes, and neither contains the other.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

N19
Unspecified kidney failure
↔
K76.7
Hepatorenal syndrome

What we found

Yes, when both are documented.N19 carries an Excludes2 note covering K76.7: “hepatorenal syndrome (K76.7)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

  • Section I.A.12.b — Excludes2 · applies to: Excludes2

    A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.

    ICD-10-CM Official Guidelines FY2027

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

Similar descriptions do not make codes interchangeable. The documentation and the official instructions decide which code applies.

Official descriptionDiffers
K76.7

Hepatorenal syndrome

N19

Unspecified kidney failure

StatusSame for both
Billable
Excludes1Differs
K76.7
  • hepatorenal syndrome following labor and delivery (O90.41)
  • postprocedural hepatorenal syndrome (K91.83)
  • jaundice NOS (R17)
N19
  • acute kidney failure (N17.-)
  • chronic kidney disease (N18.-)
  • chronic uremia (N18.9)
  • extrarenal uremia (R39.2)
  • prerenal uremia (R39.2)
  • renal insufficiency (acute) (N28.9)
  • uremia of newborn (P96.0)
Excludes2Differs
K76.7
  • alcoholic liver disease (K70.-)
  • amyloid degeneration of liver (E85.-)
  • cystic disease of liver (congenital) (Q44.6)
  • hepatic vein thrombosis (I82.0)
  • hepatomegaly NOS (R16.0)
  • pigmentary cirrhosis (of liver) (E83.110)
  • portal vein thrombosis (I81)
  • toxic liver disease (K71.-)
  • hemochromatosis (E83.11-)
  • Reye's syndrome (G93.7)
  • viral hepatitis (B15-B19)
  • Wilson's disease (E83.01)
N19
  • congenital renal failure (P96.0)
  • drug- and heavy-metal-induced tubulo-interstitial and tubular conditions (N14.-)
  • hemolytic-uremic syndrome (D59.3-)
  • hepatorenal syndrome (K76.7)
  • postpartum hepatorenal syndrome (O90.41)
  • posttraumatic renal failure (T79.5)
  • 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)
CategoryDiffers
K76.7

K76 Other diseases of liver

N19

Is itself a category

ChapterDiffers
K76.7

K00-K95 — Diseases of the Digestive System (K00-K95)

N19

N00-N99 — Diseases of the Genitourinary System (N00-N99)

IncludesDiffers
K76.7

None at this code

N19
  • Uremia NOS

No Code first, Use additional code, Code also and 7th character note at either code.

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on. In a row that differs, each code’s own notes are listed under it, and the notes every code shares are listed once beneath them.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources