N18.4: Chronic kidney disease, stage 4 (severe)
N18.4, chronic kidney disease, stage 4 (severe), is listed as a covered diagnosis in 14 Medicare billing and coding articles that apply to 28 HCPCS Level II codes, including G0127 (Trimming of dystrophic nails, any number), J0881 (Injection, darbepoetin alfa, 1 microgram (non-esrd use)), J0885 (Injection, epoetin alfa, (for non-esrd use), 1000 units). The articles come from 7 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with N18.4 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0127 | Trimming of dystrophic nails, any number | Special coverage instructions apply | — | 7 |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | Special coverage instructions apply | — | 4 |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | Special coverage instructions apply | — | 4 |
| Q5106 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units | Special coverage instructions apply | — | 4 |
| J0882 | Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) | Special coverage instructions apply | — | 4 |
| Q5105 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units | Special coverage instructions apply | — | 4 |
| J0890 | Injection, peginesatide, 0.1 mg (for esrd on dialysis) | Carrier judgment | — | 4 |
| Q4081 | Injection, epoetin alfa, 100 units (for esrd on dialysis) | Special coverage instructions apply | — | 4 |
| J0888 | Injection, epoetin beta, 1 microgram, (for non esrd use) | Special coverage instructions apply | — | 3 |
| J0887 | Injection, epoetin beta, 1 microgram, (for esrd on dialysis) | Special coverage instructions apply | — | 3 |
| C8900 | Magnetic resonance angiography with contrast, abdomen | Special coverage instructions apply | — | 3 |
| C8901 | Magnetic resonance angiography without contrast, abdomen | Special coverage instructions apply | — | 3 |
| C8902 | Magnetic resonance angiography without contrast followed by with contrast, abdomen | Special coverage instructions apply | — | 3 |
| C8909 | Magnetic resonance angiography with contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 3 |
| C8910 | Magnetic resonance angiography without contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 3 |
| C8911 | Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 3 |
| C8912 | Magnetic resonance angiography with contrast, lower extremity | Special coverage instructions apply | — | 3 |
| C8913 | Magnetic resonance angiography without contrast, lower extremity | Special coverage instructions apply | — | 3 |
| C8914 | Magnetic resonance angiography without contrast followed by with contrast, lower extremity | Special coverage instructions apply | — | 3 |
| C8918 | Magnetic resonance angiography with contrast, pelvis | Special coverage instructions apply | — | 3 |
| C8919 | Magnetic resonance angiography without contrast, pelvis | Special coverage instructions apply | — | 3 |
| C8920 | Magnetic resonance angiography without contrast followed by with contrast, pelvis | Special coverage instructions apply | — | 3 |
| C8931 | Magnetic resonance angiography with contrast, spinal canal and contents | Special coverage instructions apply | — | 2 |
| C8932 | Magnetic resonance angiography without contrast, spinal canal and contents | Special coverage instructions apply | — | 2 |
| C8933 | Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents | Special coverage instructions apply | — | 2 |
3 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing N18.4
- A57759: Billing and Coding: Routine Foot Care and Debridement of Nails (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33636, L34246
- A56795: Billing and Coding: Erythropoiesis Stimulating Agents (ESAs) (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L34633
- A57954: Billing and Coding: Routine Foot Care (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- A57193: Billing and Coding: Routine Foot Care and Debridement of Nails (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33636, L34246
- A52996: Billing and Coding: Routine Foot Care (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- A56232: Billing and Coding: Foot Care (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 1 Level II codes)
- A57188: Billing and Coding: Routine Foot Care (First Coast Service Options, Inc. (MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- A56805: Billing and Coding: Magnetic Resonance Angiography (MRA) (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 12 Level II codes). LCD with the same title: L33633, L34372, L34865
- A56680: Billing and Coding: Routine Foot Care (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- A58982: Billing and Coding: Erythropoiesis Stimulating Agents (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L39237
- A56747: Billing and Coding: Magnetic Resonance Angiography (MRA) (Wellpoint Federal (MAC - Part A, MAC - Part B); 18 Level II codes). LCD with the same title: L33633, L34372, L34865
- A56462: Billing and Coding: Erythropoiesis Stimulating Agents (ESA) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 7 Level II codes). LCD with the same title: L34356
- A60381: Billing and Coding: Erythropoiesis Stimulating Agents (Wellpoint Federal (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L39237
- A56775: Billing and Coding: Magnetic Resonance Angiography (Palmetto GBA (MAC - Part A, MAC - Part B); 18 Level II codes). LCD with the same title: L34424
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other N18 diagnoses (Chronic kidney disease (CKD))
- N18.1 — Chronic kidney disease, stage 1
- N18.2 — Chronic kidney disease, stage 2 (mild)
- N18.30 — Chronic kidney disease, stage 3 unspecified
- N18.31 — Chronic kidney disease, stage 3a
- N18.32 — Chronic kidney disease, stage 3b
- N18.5 — Chronic kidney disease, stage 5
- N18.6 — End stage renal disease
- N18.9 — Chronic kidney disease, unspecified
Frequently asked questions
Does Medicare cover N18.4 (Chronic kidney disease, stage 4 (severe))?
Medicare covers items and services, not diagnoses. 14 Medicare billing and coding articles list N18.4 as a covered diagnosis for 28 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 N18.4?
The Level II codes from the policies most specific to this diagnosis are G0127 (Trimming of dystrophic nails, any number, 7 articles); J0881 (Injection, darbepoetin alfa, 1 microgram (non-esrd use), 4 articles); J0885 (Injection, epoetin alfa, (for non-esrd use), 1000 units, 4 articles); Q5106 (Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for…, 4 articles); J0882 (Injection, darbepoetin alfa, 1 microgram (for esrd on…, 4 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list N18.4?
A57759 (Billing and Coding: Routine Foot Care and Debridement of Nails); A56795 (Billing and Coding: Erythropoiesis Stimulating Agents (ESAs)); A57954 (Billing and Coding: Routine Foot Care), and 11 more articles.
What is ICD-10-CM code N18.4?
N18.4 is the ICD-10-CM code for chronic kidney disease, stage 4 (severe), in category N18 (Chronic kidney disease (CKD)), chapter 14: Diseases of the genitourinary system.
Next steps
- Run a reimbursement report for a device billed under G0127
- Watch G0127 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0127
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 14: Diseases of the genitourinary system · All diagnoses · HCPCS lookup