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ICD-10 Coding for Leukocytes in Urine(R82.90, N39.0)

Complete ICD-10-CM coding and documentation guide for Leukocytes in Urine. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

LeukocyturiaWhite Blood Cells in Urine

Related ICD-10 Code Ranges

Complete code families applicable to Leukocytes in Urine

R82.90-R82.998Primary Range

Abnormal findings on examination of urine, unspecified

This range includes codes for abnormal findings in urine, including leukocytes without a specified cause.

Urinary tract infection, site not specified

This code is used when leukocyturia is associated with a confirmed urinary tract infection.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
R82.90Unspecified abnormal findings in urineUse when leukocytes are found in urine without a confirmed underlying condition.
  • WBC >5/HPF in women, >2/HPF in men
  • Absence of UTI symptoms
N39.0Urinary tract infection, site not specifiedUse when leukocyturia is confirmed to be due to a UTI.
  • Positive leukocyte esterase
  • Positive nitrites
  • Presence of UTI symptoms

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 leukocytes in urine

Essential facts and insights about Leukocytes in Urine

The ICD-10 code for leukocytes in urine without a confirmed diagnosis is R82.90. Use N39.0 if associated with a urinary tract infection.

Primary ICD-10-CM Codes for leukocytes in urine

Unspecified abnormal findings in urine
Billable Code

Decision Criteria

clinical Criteria

  • WBC count in urine above normal thresholds without symptoms

coding Criteria

  • No confirmed UTI or other specific diagnosis

Applicable To

  • Leukocyturia without a confirmed diagnosis

Excludes

  • Confirmed urinary tract infections (N39.0)

Clinical Validation Requirements

  • WBC >5/HPF in women, >2/HPF in men
  • Absence of UTI symptoms

Code-Specific Risks

  • Misuse when UTI is confirmed
  • Lack of specific documentation

Coding Notes

  • Ensure documentation specifies the absence of symptoms and any additional findings.

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Other abnormal findings in urine

R82.998
Use when leukocyturia is accompanied by other abnormalities like proteinuria.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Urinary tract infection, site not specified

N39.0
Use N39.0 when leukocyturia is accompanied by UTI symptoms and confirmed by culture.

Unspecified abnormal findings in urine

R82.90
Use R82.90 when leukocyturia is present without UTI symptoms.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Leukocytes in Urine to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R82.90.

Impact

Clinical: Leads to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.

Mitigation Strategy

Use structured templates for urinalysis documentation, Ensure all findings are quantified and specified

Impact

Reimbursement: Incorrect coding can lead to denied claims., Compliance: Violates ICD-10 coding guidelines., Data Quality: Affects accuracy of patient records.

Mitigation Strategy

Use N39.0 as the primary code when UTI is confirmed.

Impact

Using R82.90 instead of N39.0 when UTI is confirmed.

Mitigation Strategy

Implement coding audits and training on UTI documentation.

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 Leukocytes in Urine, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Leukocytes in Urine

Use these documentation templates to ensure complete and accurate documentation for Leukocytes in Urine. These templates include all required elements for proper coding and billing.

Primary Care Evaluation of Leukocyturia

Specialty: Primary Care

Required Elements

  • Chief complaint
  • Urinalysis results
  • Symptoms or lack thereof
  • Assessment and plan

Example Documentation

CC: Dysuria. UA: Cloudy, leukocyte esterase 3+, nitrites positive. Assessment: UTI (N39.0).

Examples: Poor vs. Good Documentation

Poor Documentation Example
Abnormal urinalysis.
Good Documentation Example
UA: WBC >50/HPF, leukocyte esterase positive, nitrites positive. Assessment: UTI (N39.0).
Explanation
The good example provides specific urinalysis findings and a clear assessment.

Need help with ICD-10 coding for Leukocytes in Urine? Ask your questions below.

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