ICD-10 Coding for Ureteral Obstruction(N13.1, N13.2, N13.6)
Complete ICD-10-CM coding and documentation guide for Ureteral Obstruction. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ureteral Obstruction
N13.0-N13.9Primary Range
Obstructive and reflux uropathy
This range includes codes for various types of ureteral obstructions, including those with hydronephrosis, strictures, and infections.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N13.1 | Hydronephrosis with ureteropelvic junction obstruction | Use when imaging confirms UPJ obstruction without a calculus. |
|
| N13.2 | Hydronephrosis with ureteral stricture, not elsewhere classified | Use when a ureteral calculus is confirmed by imaging. |
|
| N13.6 | Pyonephrosis | Use when infection is present with hydronephrosis. |
|
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 obstruction
Essential facts and insights about Ureteral Obstruction
Primary ICD-10-CM Codes for ureteral obstruction
Decision Criteria
clinical Criteria
- Imaging confirms UPJ obstruction without stones.
Applicable To
- UPJ obstruction
Excludes
- Hydronephrosis with ureteral stricture (N13.2)
Clinical Validation Requirements
- Imaging showing UPJ stricture
- Symptoms of flank pain
Code-Specific Risks
- Misidentifying the obstruction as due to a calculus
Coding Notes
- Ensure documentation specifies UPJ obstruction without stones.
N13.2 - Hydronephrosis with ureteral stricture, not elsewhere classified
Use when a ureteral calculus is confirmed by imaging.
Applicable To
- Ureteral stricture with hydronephrosis
Excludes
- Hydronephrosis with UPJ obstruction (N13.1)
Clinical Validation Requirements
- CT showing ureteral calculus
- Symptoms of flank pain and hematuria
Coding Notes
Ensure calculus is documented as the cause of obstruction.
N13.6 - Pyonephrosis
Use when infection is present with hydronephrosis.
Applicable To
- Infection with obstruction
Clinical Validation Requirements
- Urine culture positive for infection
- Imaging showing hydronephrosis with infection
Coding Notes
Document infection and obstruction clearly.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Urinary tract infection, site not specified
N39.0Differential 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 Ureteral Obstruction to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N13.1.
Impact
Clinical: May lead to inadequate treatment, Regulatory: Non-compliance with coding standards, Financial: Loss of reimbursement opportunities
Mitigation Strategy
Always check for signs of infection, Document lab results
Impact
Reimbursement: Potential underpayment due to unspecified coding, Compliance: Risk of audit failure, Data Quality: Decreased accuracy in clinical data
Mitigation Strategy
Ensure documentation specifies the cause of obstruction.
Impact
Using unspecified codes when specific causes are documented
Mitigation Strategy
Regular training on documentation specificity
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 Obstruction, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ureteral Obstruction
Use these documentation templates to ensure complete and accurate documentation for Ureteral Obstruction. These templates include all required elements for proper coding and billing.
Ureteral obstruction with calculus
Specialty: UrologyRequired Elements
- Symptoms
- Imaging findings
- Lab results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Ureteral Obstruction? Ask your questions below.