ICD-10 Coding for Obstructive Uropathy(N13.2, N13.7, N13.8, N13.9)
Complete ICD-10-CM coding and documentation guide for Obstructive Uropathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Obstructive Uropathy
N13.0-N13.9Primary Range
Obstructive and Reflux Uropathy
This range includes all codes related to obstructive and reflux uropathy, covering various causes and manifestations.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N13.2 | Hydronephrosis with renal and ureteral calculous obstruction | Use when hydronephrosis is caused by a renal or ureteral stone. |
|
| N13.7 | Vesicoureteral reflux | Use when vesicoureteral reflux is confirmed by imaging. |
|
| N13.8 | Other obstructive and reflux uropathy | Use for non-calculous causes of obstruction. |
|
| N13.9 | Unspecified obstructive and reflux uropathy | Use when the cause of obstruction is not specified. |
|
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 obstructive uropathy
Essential facts and insights about Obstructive Uropathy
Primary ICD-10-CM Codes for obstructive uropathy
Decision Criteria
clinical Criteria
- Presence of hydronephrosis with a confirmed stone
Applicable To
- Calculous obstruction
Excludes
- Obstruction without hydronephrosis
Clinical Validation Requirements
- Imaging-confirmed stone
- Hydronephrosis on ultrasound or CT
Code-Specific Risks
- Misidentifying the cause of obstruction
Coding Notes
- Ensure documentation specifies the presence of a stone causing the obstruction.
N13.7 - Vesicoureteral reflux
Use when vesicoureteral reflux is confirmed by imaging.
Applicable To
- Reflux nephropathy
Excludes
- Congenital VUR (Q62.7)
Clinical Validation Requirements
- VCUG showing reflux
- Recurrent UTIs
Coding Notes
Document the grade of reflux if available.
N13.8 - Other obstructive and reflux uropathy
Use for non-calculous causes of obstruction.
Applicable To
- Obstruction due to external compression
Excludes
- Obstruction due to calculus
Clinical Validation Requirements
- Imaging showing obstruction
- Documented cause of obstruction
Coding Notes
Ensure documentation specifies the non-calculous cause.
N13.9 - Unspecified obstructive and reflux uropathy
Use when the cause of obstruction is not specified.
Applicable To
- Unspecified obstruction
Excludes
- Specific causes of obstruction
Clinical Validation Requirements
- Lack of specific cause in documentation
Coding Notes
Encourage specificity in documentation to avoid this code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Calculus of ureter
N20.1Differential 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 Obstructive Uropathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N13.2.
Impact
Clinical: Leads to inadequate treatment plans., Regulatory: Potential audit flags for lack of specificity., Financial: May result in denied claims or reduced reimbursement.
Mitigation Strategy
Encourage detailed documentation, Use imaging to confirm diagnosis
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient care.
Mitigation Strategy
Ensure imaging and clinical documentation confirm the cause.
Impact
High use of unspecified codes can trigger audits.
Mitigation Strategy
Promote detailed documentation and specific coding.
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 Obstructive Uropathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Obstructive Uropathy
Use these documentation templates to ensure complete and accurate documentation for Obstructive Uropathy. These templates include all required elements for proper coding and billing.
Obstructive uropathy due to ureteral stone
Specialty: UrologyRequired Elements
- Imaging confirmation
- Stone size and location
- Hydronephrosis presence
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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