ICD-10 Coding for Kidney Stones(N20.0, N13.2)
Complete ICD-10-CM coding and documentation guide for Kidney Stones. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Kidney Stones
N20-N23Primary Range
Calculus of kidney and ureter
This range includes codes for kidney and ureteral stones, which are the primary focus for nephrolithiasis.
Hydronephrosis with renal and ureteral calculous obstruction
Used when hydronephrosis is present due to a stone, indicating obstruction.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N20.0 | Calculus of kidney | Use when a kidney stone is present without obstruction or hydronephrosis. |
|
| N13.2 | Hydronephrosis with renal and ureteral calculous obstruction | Use when hydronephrosis is present due to a stone. |
|
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: ICD-10 code for nephrolithiasis
Essential facts and insights about Kidney Stones
Primary ICD-10-CM Codes for nephrolithiasis
Decision Criteria
clinical Criteria
- Presence of kidney stone without hydronephrosis
Applicable To
- Renal calculus
- Kidney stone
Excludes
- N13.2 (Hydronephrosis with obstruction)
Clinical Validation Requirements
- Imaging confirming renal stone without obstruction
Code-Specific Risks
- Incorrectly coding when hydronephrosis is present
Coding Notes
- Ensure no hydronephrosis is documented when using this code.
N13.2 - Hydronephrosis with renal and ureteral calculous obstruction
Use when hydronephrosis is present due to a stone.
Applicable To
- Obstructive uropathy due to stone
Excludes
- N20.0 (Calculus of kidney)
Clinical Validation Requirements
- Imaging showing hydronephrosis with stone obstruction
Coding Notes
Do not use with N20.0 due to Excludes1 note.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Kidney Stones to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N20.0.
Impact
Clinical: Impacts treatment decisions., Regulatory: Can lead to coding errors., Financial: May affect reimbursement rates.
Mitigation Strategy
Always include location in documentation., Use specific terminology.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Violates ICD-10 Excludes1 notes., Data Quality: Leads to inaccurate clinical data.
Mitigation Strategy
Use N13.2 alone when hydronephrosis is present.
Impact
Using N20.0 with N13.2 can trigger audits.
Mitigation Strategy
Educate coders on Excludes1 notes.
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 Kidney Stones, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Kidney Stones
Use these documentation templates to ensure complete and accurate documentation for Kidney Stones. These templates include all required elements for proper coding and billing.
Urology Progress Note
Specialty: UrologyRequired Elements
- Patient history
- Imaging results
- Lab findings
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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