ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 N16

Billable / Specific

Renal tubulo-interstitial disorders in diseases classified elsewhere

N16
Block
2
Synonyms
19
LCDs
4
Payer Policies
0
Linked CPTs

About ICD-10-CM N16

ICD-10-CM code N16 represents Renal tubulo-interstitial disorders in diseases classified elsewhere. This is a billable/specific code in the Genitourinary System chapter (block N16). The 2026 edition of ICD-10-CM N16 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under N16. Per CMS ICD-10-CM Tabular 2026.

  • Pyelonephritis
  • Tubulo-interstitial nephritis

Type 1 Excludes

Pure excludes, these codes can never be coded together with N16. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • diphtheritic pyelonephritis and tubulo-interstitial nephritis (A36.84)
  • pyelonephritis and tubulo-interstitial nephritis in candidiasis (B37.49)
  • pyelonephritis and tubulo-interstitial nephritis in cystinosis (E72.04)
  • pyelonephritis and tubulo-interstitial nephritis in salmonella infection (A02.25)
  • pyelonephritis and tubulo-interstitial nephritis in sarcoidosis (D86.84)
  • pyelonephritis and tubulo-interstitial nephritis in Sjogren syndrome (M35.04)
  • pyelonephritis and tubulo-interstitial nephritis in systemic lupus erythematosus (M32.15)
  • pyelonephritis and tubulo-interstitial nephritis in toxoplasmosis (B58.83)
  • renal tubular degeneration in diabetes (E08-E13 with .29)
  • syphilitic pyelonephritis and tubulo-interstitial nephritis (A52.75)

Coding Notes

Code First

  • underlying disease, such as:
  • brucellosis (A23.0-A23.9)
  • cryoglobulinemia (D89.1)
  • glycogen storage disease (E74.0-)
  • leukemia (C91-C95)
  • lymphoma (C81.0-C85.9, C96.0-C96.9)
  • multiple myeloma (C90.0-)
  • sepsis (A40.0-A41.9)
  • Wilson's disease (E83.01)

Medicare LCD Coverage for N16

Local Coverage Determinations (LCDs) from CMS MACs that list N16 as a covered diagnosis.

19 LCDs

Showing top 10 of 19 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74170 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74177 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74160 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74178 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74150 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72194 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74176 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72192 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72193 →
CMS LCD: Billing and Coding: Retroperitoneal Ultrasound
Article ID: 55336, Effective: 2025-10-01 00:00:00, 797 covered, 0 non-covered
CPT 76775 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing N16.

4 policies

4 Medicare

Billing and Coding: Retroperitoneal Ultrasound
Policy ID: ART-55336
Billing and Coding: Rituximab
Policy ID: ART-56380
Billing and Coding: CT of the Abdomen and Pelvis
Policy ID: ART-56421
Billing and Coding: Serum Magnesium
Policy ID: ART-57189

CPT Codes Commonly Billed with N16

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for N16

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert N16 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
N16 58381 10000
N16 59081 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 N16, Billing FAQ

Is ICD-10 code N16 billable? +

Yes, N16 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to N16? +

ICD-10 N16 includes: Pyelonephritis; Tubulo-interstitial nephritis.

What codes are Type 1 Excludes for N16? +

Type 1 Excludes (never code together with N16): diphtheritic pyelonephritis and tubulo-interstitial nephritis (A36.84); pyelonephritis and tubulo-interstitial nephritis in candidiasis (B37.49); pyelonephritis and tubulo-interstitial nephritis in cystinosis (E72.04)

What ICD-9 codes does N16 map to? +

Per CMS GEMs, N16 maps to ICD-9 codes: 58381, 59081. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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