ICD-10 Coding for Ureterolithiasis(N20.1, N13.2)
Complete ICD-10-CM coding and documentation guide for Ureterolithiasis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ureterolithiasis
N20-N23Primary Range
Calculus of kidney and ureter
This range includes codes for stones in the kidney and ureter, specifically addressing ureterolithiasis.
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 stone is confirmed in the ureter without hydronephrosis. |
|
| N13.2 | Hydronephrosis with ureteral obstruction | Use when hydronephrosis is present due to ureteral 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 ureterolithiasis
Essential facts and insights about Ureterolithiasis
Primary ICD-10-CM Codes for ureterolithiasis
Decision Criteria
clinical Criteria
- Presence of ureteral stone confirmed by imaging
documentation Criteria
- Laterality and specific location within the ureter
Applicable To
- Ureteral stone
- Ureteral calculus
Excludes
- N13.2 - Hydronephrosis with ureteral obstruction
Clinical Validation Requirements
- Imaging confirmation of stone in ureter
- Symptoms such as flank pain and hematuria
Code-Specific Risks
- Incorrectly coding as N20.0 (kidney stone)
- Omitting laterality
Coding Notes
- Ensure laterality is documented and confirmed by imaging.
N13.2 - Hydronephrosis with ureteral obstruction
Use when hydronephrosis is present due to ureteral obstruction.
Applicable To
- Obstructive uropathy with hydronephrosis
Excludes
- N20.1 - Calculus of ureter without hydronephrosis
Clinical Validation Requirements
- Imaging showing hydronephrosis and obstruction
- Symptoms of obstruction
Coding Notes
Do not use with N20.1 due to Excludes1 note.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Gross hematuria
R31.0Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Ureterolithiasis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N20.1.
Impact
Clinical: May lead to incorrect treatment side., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Use templates that prompt for laterality, Regular audits of documentation
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Violates Excludes1 note in ICD-10., Data Quality: Leads to inaccurate clinical data.
Mitigation Strategy
Use N13.2 alone if hydronephrosis is present.
Impact
Using N20.1 and N13.2 together despite Excludes1 note.
Mitigation Strategy
Educate coders on Excludes1 notes and proper code selection.
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 Ureterolithiasis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ureterolithiasis
Use these documentation templates to ensure complete and accurate documentation for Ureterolithiasis. These templates include all required elements for proper coding and billing.
Emergency Department Visit for Ureterolithiasis
Specialty: Emergency MedicineRequired Elements
- Chief complaint
- History of present illness
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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