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N17.9 ICD-10-CM Code: Acute kidney failure, unspecified

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Risk adjustment
CMS-HCC V22 category 135

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 673 — OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC (MDC 11)
  • MS-DRG 674 — OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC (MDC 11)
  • MS-DRG 675 — OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC (MDC 11)
  • MS-DRG 682 — RENAL FAILURE WITH MCC (MDC 11)
  • MS-DRG 683 — RENAL FAILURE WITH CC (MDC 11)
  • MS-DRG 684 — RENAL FAILURE WITHOUT CC/MCC (MDC 11)
  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for N17.9 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on N17.9 itself; “inherited from” names the category or block whose note applies here.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Acute kidney injury (nontraumatic)

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from N17

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Code Also

Additional codes that may be required to fully describe the encounter.

  • associated underlying condition

Source: inherited from N17

Coder workflow for N17.9

MedCoder structured workflow — derived from this code’s own official record

Before you code N17.9

  1. Unspecified does not mean incorrect. When the record gives no greater specificity, N17.9 may be the appropriate code. Check the record for detail that supports a more specific sibling — in this subcategory the siblings differ by acute versus chronic, the presence or absence of the associated condition. An unspecified code is for records that do not provide the detail a more specific code needs; a query, not an assumption, is the route to specificity (Guidelines I.A.9.b, I.B.18).

    ReviewN17.0, N17.1, N17.2, N17.8

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with N17.9. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the record document the detail a more specific sibling code needs?
    Yes → Review the specific siblings in this subcategory.
    No → Continue — N17.9 is appropriate when the documentation goes no further.

    ReviewN17.0, N17.1, N17.2, N17.8

  2. Does the documentation support a condition named in N17.9’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewT79.5

Consider N17.9. Then review the Code Also note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Acuity
Acute or chronic as documented; when both are documented and separate codes exist, both are reported with the acute code first (Guidelines I.B.8).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

  • Excludes1 — check before selecting N17.9(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with N17.9: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareT79.5

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of N17.9(11 notes)

    Coding workflow: The conditions named in this note are not included in N17.9. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareS37.0, P96.0, N14, R39.2, D59.3, K76.7

    See the official tabular notes · Guidelines I.A.12.b

  • Code Also — related condition(1 note)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    See the official tabular notes · Guidelines I.A.17

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Acute kidney failure, unspecified is a billable ICD-10-CM diagnosis code (N17.9).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (3)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Coding Notes

MedCoder editorial — not official ICD-10-CM text; reviewed against the cited source

What this code means

N17.9 reports acute kidney failure with no documented lesion type, and it is where “acute kidney injury” lands — “Acute kidney injury (nontraumatic)” is the code’s own inclusion term. The N17 rows above it (N17.0 tubular necrosis, N17.1 cortical necrosis, N17.2 medullary necrosis) claim records that name the lesion.

Coding guidance

  • When the provider documents acute kidney injury and no more specific acute kidney-failure type (or an applicable alternative pathway) is documented, N17.9 is the usual coding pathway — the specific N17 rows require a named pathology, not a severity stage.
  • The trauma boundary runs through two notes: posttraumatic renal failure is an Excludes1 (T79.5), and traumatic kidney injury an Excludes2 (S37.0-). A documented traumatic mechanism leaves this code entirely.
  • Acute-on-chronic kidney disease takes two codes: N17.9 for the acute failure and the N18 stage code for the chronic disease — no Excludes note bars the pair.
  • The code carries a Code Also note for the associated underlying condition, when documented.

Decision-rule scenarios

Documentation: The record documents “AKI on CKD stage 3b.”

Coding question: How many codes, and in what order?

Rule: Both conditions are separately represented when both are documented — the acute failure and the chronic stage (N18.32 territory by the documented substage). Sequencing follows the applicable coding and encounter rules; the deciding elements are the documented acuity of the event and the recorded CKD stage.

Documentation: A discharge summary states “acute tubular necrosis.”

Coding question: Does N17.9 still apply?

Rule: No — a named lesion selects the specific row (acute tubular necrosis has its own N17 code). N17.9 is for acute failure with the lesion unstated; the deciding element is the documented pathology.

Scenarios state the decision rule, not a code assignment — code selection always follows the provider's documentation and the ICD-10-CM Official Guidelines.

Documentation checklist

  • The acuity — that the failure or injury is acute, not a chronic stage.
  • Any named lesion (tubular, cortical, medullary necrosis), which selects a specific N17 row.
  • A traumatic mechanism, which moves the record out of N17 altogether.
  • The underlying condition, for the Code Also note, and any coexisting CKD stage.

Codes are assigned from provider documentation; a coder never infers a diagnosis.

Common mistakes

  • Coding “AKI” to an injury chapter code — nontraumatic acute kidney injury is N17.9’s own inclusion term.
  • Dropping the N18 stage when AKI arrives on top of documented CKD — both are reported.
  • Using N17.9 for a documented posttraumatic renal failure, which the Excludes1 routes to T79.5.

Clinical context (coding perspective)

“AKI” replaced “acute renal failure” in clinical writing years ago, and the classification followed by adding the inclusion term rather than a new code — which is why the abbreviation maps cleanly here despite the code title still reading “acute kidney failure.”

Written and reviewed by MedCoder against the official ICD-10-CM files; educational, not medical or billing advice. The official tabular notes and guidelines above take precedence in every case.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. 1 Code Also note — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  2. 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  3. 11 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name N17.9 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: N19 — Unspecified kidney failure (via N17.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 3 Excludes2 notes across 3 chapters: I12 — Hypertensive chronic kidney disease (via N17.-), N14.11 — Contrast-induced nephropathy (via N17.-), S37.0 — Injury of kidney.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 1 Code First instruction: I5A — Non-ischemic myocardial injury (non-traumatic) (via N17.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

Referenced by 5 Use Additional Code instructions across 4 chapters: B33.4 — Hantavirus (cardio)-pulmonary syndrome [HPS] [HCPS], I75.81 — Atheroembolism of kidney (via N17.-), M31.11 — Hematopoietic stem cell transplantation-associated thrombotic microangiopathy [HSCT-TMA] (via N17.-), R65.11 — Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction (via N17.-), R65.2 — Severe sepsis (via N17.-).

These codes instruct coders to additionally report this code when it applies.

Referenced by 13 Code Also instructions across 4 chapters: D59.3 — Hemolytic-uremic syndrome (via N17.-), I16.1 — Hypertensive emergency (via N17.-), M35.81 — Multisystem inflammatory syndrome (via N17.-), N00 — Acute nephritic syndrome (via N17.-), N00-N08 — Glomerular diseases (N00-N08) (via N17.-), N01 — Rapidly progressive nephritic syndrome (via N17.-), N02 — Recurrent and persistent hematuria (via N17.-), N03 — Chronic nephritic syndrome (via N17.-), N04 — Nephrotic syndrome (via N17.-), N05 — Unspecified nephritic syndrome (via N17.-), N06 — Isolated proteinuria with specified morphological lesion (via N17.-), N07 — Hereditary nephropathy, not elsewhere classified (via N17.-), N08 — Glomerular disorders in diseases classified elsewhere (via N17.-).

These codes suggest coding this condition alongside when both are present.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 301 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 8 MS-DRGs: DRG 673 (MDC 11), DRG 674 (MDC 11), DRG 675 (MDC 11), DRG 682 (MDC 11), DRG 683 (MDC 11), DRG 684 (MDC 11), DRG 791 (MDC 15), DRG 793 (MDC 15).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):GEN002 — Acute and unspecified renal failure (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Acute and unspecified renal failure).

K76.7 — Hepatorenal syndrome, K91.83 — Postprocedural hepatorenal syndrome, N17.0 — Acute kidney failure with tubular necrosis, N17.1 — Acute kidney failure with acute cortical necrosis, N17.2 — Acute kidney failure with medullary necrosis, N17.8 — Other acute kidney failure, N19 — Unspecified kidney failure, N99.0 — Postprocedural (acute) (chronic) kidney failure, O90.4 — Postpartum acute kidney failure, O90.41 — Hepatorenal syndrome following labor and delivery, O90.49 — Other postpartum acute kidney failure

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Failure, failed”, “Necrosis, necrotic”; these codes share that main term but sit in a different category of the Tabular List.

K86.89 — Other specified diseases of pancreas (pancreas), K90.83 — Intestinal failure (intestinal), K91.82 — Postprocedural hepatic failure (hepatic, postprocedural), M27.2 — Inflammatory conditions of jaws (jaw), M27.61 — Osseointegration failure of dental implant (dental implant, pre-integration), M27.62 — Post-osseointegration biological failure of dental implant (dental implant, due to, occlusal trauma), M27.63 — Post-osseointegration mechanical failure of dental implant (dental implant, post-osseointegration, mechanical), M27.69 — Other endosseous dental implant failure (dental implant), M87.00 — Idiopathic aseptic necrosis of unspecified bone (bone, aseptic or avascular, idiopathic), M87.9 — Osteonecrosis, unspecified (bone), N18.6 — End stage renal disease (renal, end stage), N18.9 — Chronic kidney disease, unspecified (renal, chronic), N19 — Unspecified kidney failure (renal), N28.0 — Ischemia and infarction of kidney (kidney), N32.89 — Other specified disorders of bladder (bladder), N50.89 — Other specified disorders of the male genital organs (testis), N52.9 — Male erectile dysfunction, unspecified (erection), N64.1 — Fat necrosis of breast (breast), N70.92 — Oophoritis, unspecified (ovary), N89.8 — Other specified noninflammatory disorders of vagina (vagina), +175 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Gamma-glutamyl Transferase (GGT) Test, HIV Screening Test, Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of N17.9 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run N17.9 with these 18 related codes in Claim Check

Hierarchy

Excludes2

  • S37.0 — Injury of kidney[Excludes2]: “traumatic kidney injury (S37.0-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes1 notes

Referenced by Excludes2 notes

Referenced by Code First instructions

Referenced by Use Additional Code instructions

Referenced by Code Also instructions (13)

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 11 — Diseases and Disorders of the Kidney and Urinary Tract[MDC crossing]: “Diseases and Disorders of the Kidney and Urinary Tract — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 3,574 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
  • MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period[MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Failure, failed, renal, acute[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Injury, kidney, acute (nontraumatic)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Necrosis, necrotic (ischemic), kidney (bilateral), acute[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Common coding questions

Does N17.9 cover “acute kidney injury”?

Yes — “Acute kidney injury (nontraumatic)” is N17.9’s own inclusion term. A TRAUMATIC kidney injury is different: posttraumatic renal failure is an Excludes1 (T79.5) and traumatic kidney injury an Excludes2 (S37.0-), so the mechanism in the record decides the chapter.

Can N17.9 and an N18 CKD code be reported together?

Yes, when both acute kidney failure and chronic kidney disease are documented — no Excludes note bars the pair, and N17.9 carries a Code Also note for the associated underlying condition. The acute-plus-chronic convention is walked in Acute and chronic together.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary, coding notes, decision checklist and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "N17.9 — Acute kidney failure, unspecified." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/n17.9-acute-kidney-failure-unspecified

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Acute kidney failure, unspecified

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to N17.9 in its code family, with their registry titles.

View all codes in the N17 family