ICD-10 Coding for Renal Calculus(N20.0, N20.1)
Complete ICD-10-CM coding and documentation guide for Renal Calculus. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Renal Calculus
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 renal calculus is confirmed by imaging and there is no hydronephrosis. |
|
| N20.1 | Calculus of ureter | Use when a ureteral stone is confirmed by imaging. |
|
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 renal calculus
Essential facts and insights about Renal Calculus
Primary ICD-10-CM Codes for renal calculus
Decision Criteria
clinical Criteria
- Presence of renal calculus confirmed by imaging
coding Criteria
- Do not use with N13.2 if hydronephrosis is present
Applicable To
- Kidney stone
- Renal calculus
Excludes
- Hydronephrosis with calculus obstruction (N13.2)
Clinical Validation Requirements
- Imaging confirmation (CT or ultrasound)
- Symptoms such as flank pain or hematuria
Code-Specific Risks
- Incorrectly coding with N13.2 when hydronephrosis is present
Coding Notes
- Ensure imaging confirms the presence of a renal calculus before coding.
N20.1 - Calculus of ureter
Use when a ureteral stone is confirmed by imaging.
Applicable To
- Ureteral stone
Clinical Validation Requirements
- Imaging confirmation of ureteral stone
Coding Notes
Ensure imaging confirms the presence of a ureteral calculus.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Hydronephrosis with calculus obstruction
N13.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Renal Calculus to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N20.0.
Impact
Clinical: Misdiagnosis risk., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Ensure imaging reports are detailed and included in records.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 coding rules., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use N13.2 when hydronephrosis is present with a calculus.
Impact
Using N20.0 with N13.2.
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 Renal Calculus, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Renal Calculus
Use these documentation templates to ensure complete and accurate documentation for Renal Calculus. These templates include all required elements for proper coding and billing.
Urology Progress Note
Specialty: UrologyRequired Elements
- Assessment
- Plan
- Imaging results
- Symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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