ICD-10 Coding for Ureteric Calculus(N20.1, N13.2)
Complete ICD-10-CM coding and documentation guide for Ureteric Calculus. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ureteric Calculus
N20-N23Primary Range
Calculus of kidney and ureter
This range includes codes for stones located in the kidney and ureter, which are relevant for ureteric 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 |
|---|---|---|---|
| N20.1 | Calculus of ureter | Use when a ureteral stone is present without obstruction or hydronephrosis. |
|
| N13.2 | Hydronephrosis with ureteral obstruction | Use when a ureteral stone causes hydronephrosis or obstruction. |
|
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 ureteric calculus
Essential facts and insights about Ureteric Calculus
Primary ICD-10-CM Codes for ureteric calculus
Decision Criteria
clinical Criteria
- Presence of ureteral stone without hydronephrosis
Applicable To
- Ureteral stone without obstruction
Excludes
- N13.2 (Hydronephrosis with ureteral obstruction)
Clinical Validation Requirements
- Imaging evidence of ureteral stone without hydronephrosis
Code-Specific Risks
- Incorrectly coding when hydronephrosis is present.
Coding Notes
- Ensure documentation specifies the absence of hydronephrosis.
N13.2 - Hydronephrosis with ureteral obstruction
Use when a ureteral stone causes hydronephrosis or obstruction.
Applicable To
- Obstructive ureteral stone with hydronephrosis
Clinical Validation Requirements
- Imaging showing hydronephrosis and ureteral stone
Coding Notes
Prioritize N13.2 over N20.1 when obstruction is present.
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 Ureteric Calculus to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N20.1.
Impact
Clinical: Impacts treatment decisions, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Always document left, right, or bilateral, Use templates that prompt for laterality
Impact
Reimbursement: Incorrect DRG assignment may occur., Compliance: Violates Excludes1 note rules., Data Quality: Leads to inaccurate clinical data.
Mitigation Strategy
Use only N13.2 when hydronephrosis is present.
Impact
Using N20.1 and N13.2 together despite Excludes1 notes.
Mitigation Strategy
Educate coders on Excludes1 rules and provide decision trees.
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 Ureteric Calculus, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ureteric Calculus
Use these documentation templates to ensure complete and accurate documentation for Ureteric Calculus. These templates include all required elements for proper coding and billing.
Acute Ureteric Colic
Specialty: Emergency MedicineRequired Elements
- Patient history
- Imaging findings
- Symptoms
- Diagnosis
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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