ICD-10 Coding for Ureteral Stone with Hydronephrosis(N13.2, N13.6)
Complete ICD-10-CM coding and documentation guide for Ureteral Stone with Hydronephrosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ureteral Stone with Hydronephrosis
N13.0-N13.9Primary Range
Obstructive and Reflux Uropathy
This range includes conditions related to hydronephrosis and obstruction due to stones.
Calculus of Kidney and Ureter
This range includes codes for stones without hydronephrosis.
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 confirmed with a ureteral or renal calculus. |
|
| N13.6 | Pyonephrosis | Use when infection is present with hydronephrosis and 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 ureteral stone with hydronephrosis
Essential facts and insights about Ureteral Stone with Hydronephrosis
Primary ICD-10-CM Codes for ureter stone with hydronephrosis
Decision Criteria
clinical Criteria
- Imaging confirms hydronephrosis with stone
documentation Criteria
- Explicit mention of hydronephrosis due to stone
Applicable To
- Hydronephrosis due to ureteral stone
Clinical Validation Requirements
- CT or MRI showing hydronephrosis and stone location
- Symptoms such as flank pain, hematuria
Code-Specific Risks
- Incorrectly using N20.1 when hydronephrosis is present
Coding Notes
- Ensure documentation explicitly links hydronephrosis to the stone.
N13.6 - Pyonephrosis
Use when infection is present with hydronephrosis and stone.
Applicable To
- Infected hydronephrosis
Excludes
- N13.2 (Hydronephrosis with renal and ureteral calculous obstruction)
Clinical Validation Requirements
- Positive urine culture
- Fever and leukocytosis
Coding Notes
Ensure infection is documented alongside hydronephrosis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Calculus of ureter
N20.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Ureteral Stone with Hydronephrosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N13.2.
Impact
Clinical: Misrepresentation of patient condition, Regulatory: Potential for audit issues, Financial: Denial of claims due to incorrect coding
Mitigation Strategy
Educate clinicians on documentation standards, Use templates with required fields
Impact
Reimbursement: Incorrect DRG assignment may reduce reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Verify imaging reports for hydronephrosis before coding.
Impact
Using N20.1 instead of N13.2 when hydronephrosis is present.
Mitigation Strategy
Regular training and audits of coding practices.
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 Ureteral Stone with Hydronephrosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ureteral Stone with Hydronephrosis
Use these documentation templates to ensure complete and accurate documentation for Ureteral Stone with Hydronephrosis. These templates include all required elements for proper coding and billing.
Emergency Department Presentation
Specialty: Emergency MedicineRequired Elements
- Patient age and sex
- Symptoms and pain score
- Imaging findings
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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