ICD-10 Coding for Renal Colic(N23, N20.1, N13.2)
Complete ICD-10-CM coding and documentation guide for Renal Colic. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Renal Colic
N20-N23Primary Range
Urolithiasis
This range includes codes for kidney stones and related conditions, including renal colic.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N23 | Unspecified renal colic | Use when imaging does not confirm a stone but symptoms suggest renal colic. |
|
| N20.1 | Calculus of ureter | Use when a ureteral stone is confirmed by imaging. |
|
| N13.2 | Hydronephrosis with ureteral stone | Use when hydronephrosis is present with a ureteral stone. |
|
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 renal colic
Essential facts and insights about Renal Colic
Primary ICD-10-CM Codes for renal colic
Decision Criteria
clinical Criteria
- Sudden onset of severe flank pain without imaging confirmation of stone
Applicable To
- Renal colic without confirmed stone
Excludes
- N13.2 (Hydronephrosis with ureteral stone)
Clinical Validation Requirements
- Sudden severe flank pain
- Negative imaging for stones
Code-Specific Risks
- Incorrectly using when a stone is confirmed
Coding Notes
- Ensure imaging results are documented to avoid misuse.
N20.1 - Calculus of ureter
Use when a ureteral stone is confirmed by imaging.
Applicable To
- Ureteral stone confirmed by imaging
Excludes
- N13.2 (Hydronephrosis with ureteral stone)
Clinical Validation Requirements
- Imaging confirmation of ureteral stone
- Presence of hematuria
Coding Notes
Document stone size and location for accurate coding.
N13.2 - Hydronephrosis with ureteral stone
Use when hydronephrosis is present with a ureteral stone.
Applicable To
- Hydronephrosis due to ureteral stone
Excludes
- N20.x (Calculus of kidney and ureter)
Clinical Validation Requirements
- Imaging showing hydronephrosis and ureteral stone
Coding Notes
Ensure hydronephrosis is documented with imaging.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 Renal Colic to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N23.
Impact
Clinical: May lead to incorrect diagnosis coding., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Specify pain location and characteristics, Include imaging results in documentation
Impact
Reimbursement: May result in lower DRG assignment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use N20.x or N21.x when a stone is confirmed.
Impact
Reimbursement: Incorrect DRG assignment., Compliance: Violation of Excludes1 note., Data Quality: Inconsistent clinical data.
Mitigation Strategy
Use N13.2 alone when hydronephrosis is present.
Impact
Failure to document imaging results can lead to incorrect coding.
Mitigation Strategy
Ensure all imaging findings are included in the clinical note.
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 Renal Colic, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Renal Colic
Use these documentation templates to ensure complete and accurate documentation for Renal Colic. These templates include all required elements for proper coding and billing.
Emergency Department Visit
Specialty: Emergency MedicineRequired Elements
- Onset and character of pain
- Associated symptoms
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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