Is N28.1 a billable ICD-10-CM code?

Yes. N28.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does N28.1 sit in the tabular list?

Diseases of the genitourinary system (N00-N99), in the block Other disorders of kidney and ureter (N25-N29).

What cannot be coded together with N28.1?

N28.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

N28.1

N28.1 — Cyst of kidney, acquired

Billable / specific codeICD-10-CM

N28.1 is a billable, specific ICD-10-CM code for cyst of kidney, acquired. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

cystic kidney disease (congenital) (Q61.-)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Cyst (multiple) (solitary) of kidney (acquired)

Other codes that can never be billed with N28.1

These codes carry an Excludes1 note pointing at N28.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading N28.1 alone.

Q61Cystic kidney disease

Risk adjustment

N28.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

N28.1 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A55336Billing and Coding: Retroperitoneal Ultrasound
A56421Billing and Coding: CT of the Abdomen and Pelvis

How N28.1 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to N28.1.

Cyst›kidney
Cyst›paranephric
Cyst›peripelvic(lymphatic)
Solitary›cyst, kidney
Cyst›kidney›acquired
Cyst›kidney›simple
Cyst›kidney›solitary(single)
Cyst›solitary›kidney
Cyst›kidney›solitary›acquired

Related codes at this level

Codes that share N28. If N28.1 is not quite right, the correct code is usually one of these.

Questions about N28.1

Is N28.1 a billable ICD-10-CM code?: Yes. N28.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does N28.1 sit in the tabular list?: Diseases of the genitourinary system (N00-N99), in the block Other disorders of kidney and ureter (N25-N29).
What cannot be coded together with N28.1?: N28.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.