ICD-10 Coding for Ureteropelvic Junction Obstruction(N13.0, Q62.11)
Complete ICD-10-CM coding and documentation guide for Ureteropelvic Junction Obstruction. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ureteropelvic Junction Obstruction
N13-N13.9Primary Range
Obstructive and reflux uropathy
This range includes codes for acquired ureteropelvic junction obstruction, which is a primary concern in adult patients.
Congenital malformations of the urinary system
This range covers congenital ureteropelvic junction obstruction, relevant for pediatric and prenatal cases.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N13.0 | Hydronephrosis with ureteropelvic junction obstruction | Use for acquired UPJ obstruction with hydronephrosis in adults. |
|
| Q62.11 | Congenital hydronephrosis | Use for congenital UPJ obstruction identified in prenatal or early childhood settings. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: How to code UPJ obstruction with hydronephrosis?
Essential facts and insights about Ureteropelvic Junction Obstruction
Primary ICD-10-CM Codes for look ureteropelvic
Decision Criteria
clinical Criteria
- Presence of hydronephrosis and acquired obstruction
documentation Criteria
- Detailed imaging report confirming obstruction
Applicable To
- Acquired UPJ obstruction with hydronephrosis
Excludes
- Congenital UPJ obstruction (Q62.11)
Clinical Validation Requirements
- Imaging-confirmed hydronephrosis
- Demonstrated ureteropelvic junction narrowing
Code-Specific Risks
- Misclassification if congenital cause is not ruled out
Coding Notes
- Ensure documentation specifies acquired nature and presence of hydronephrosis.
Q62.11 - Congenital hydronephrosis
Use for congenital UPJ obstruction identified in prenatal or early childhood settings.
Applicable To
- Congenital UPJ obstruction
Excludes
- Acquired UPJ obstruction (N13.0)
Clinical Validation Requirements
- Prenatal ultrasound findings
- Absence of secondary causes
Coding Notes
Ensure documentation specifies congenital nature and prenatal diagnosis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other complications of procedures, not elsewhere classified
T81.89XADifferential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Ureteropelvic Junction Obstruction to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N13.0.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Use detailed imaging reports, Document symptomatology clearly
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Misclassification may result in compliance issues., Data Quality: Affects accuracy of patient records and data analysis.
Mitigation Strategy
Verify patient history and imaging to confirm congenital vs. acquired nature.
Impact
High risk of coding errors between congenital and acquired cases.
Mitigation Strategy
Implement thorough review of patient history and imaging.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Ureteropelvic Junction Obstruction, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ureteropelvic Junction Obstruction
Use these documentation templates to ensure complete and accurate documentation for Ureteropelvic Junction Obstruction. These templates include all required elements for proper coding and billing.
Adult with acquired UPJ obstruction
Specialty: UrologyRequired Elements
- Imaging results
- Symptom description
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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