ICD-10 Coding for Urinary Obstruction(N13.2, N13.6)
Complete ICD-10-CM coding and documentation guide for Urinary Obstruction. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Urinary Obstruction
N13-N13.9Primary Range
Obstructive and reflux uropathy
This range includes codes for various types of urinary obstructions, including those caused by stones, strictures, and other blockages.
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 calculus obstruction | Use when imaging confirms stone-related obstruction. |
|
| N13.6 | Pyeloureteritis cystica with hydronephrosis | Use when obstruction, infection, and calculus are all present. |
|
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 urinary obstruction
Essential facts and insights about Urinary Obstruction
Primary ICD-10-CM Codes for urinary obstruction
Decision Criteria
clinical Criteria
- Imaging shows stone causing obstruction
Applicable To
- Hydronephrosis due to calculus
Excludes
- Hydronephrosis without obstruction
Clinical Validation Requirements
- Imaging confirmation of stone
- Symptoms of obstruction
Code-Specific Risks
- Using without imaging confirmation
Coding Notes
- Ensure imaging confirms the presence of a stone causing obstruction.
N13.6 - Pyeloureteritis cystica with hydronephrosis
Use when obstruction, infection, and calculus are all present.
Applicable To
- Obstruction with infection and calculus
Excludes
- Hydronephrosis without infection
Clinical Validation Requirements
- Documented infection
- Imaging confirmation of obstruction
Coding Notes
Ensure documentation includes all three conditions: obstruction, infection, and calculus.
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 Urinary Obstruction to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N13.2.
Impact
Clinical: May lead to incorrect treatment., Regulatory: Increases risk of audits., Financial: Potential for denied claims.
Mitigation Strategy
Ensure imaging results are included in the patient's record.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audits., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Use specific codes such as N13.2 or N13.6 when the cause of obstruction is known.
Impact
Unspecified codes can trigger audits due to lack of specificity.
Mitigation Strategy
Use the most specific code available.
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 Urinary Obstruction, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Urinary Obstruction
Use these documentation templates to ensure complete and accurate documentation for Urinary Obstruction. These templates include all required elements for proper coding and billing.
Urology Clinic Visit
Specialty: UrologyRequired Elements
- Patient history
- Imaging results
- Symptom description
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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