ICD-10 Coding for Ureteral Stone(N20.1, N13.2)
Complete ICD-10-CM coding and documentation guide for Ureteral Stone. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ureteral Stone
N20-N23Primary Range
Calculus of kidney and ureter
This range includes codes for stones located in the kidney and ureter, which are relevant for coding ureteral stones.
Obstructive and reflux uropathy
Includes codes for hydronephrosis with calculus obstruction, relevant when ureteral stones cause hydronephrosis.
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 confirmed without complications like hydronephrosis. |
|
| N13.2 | Hydronephrosis with calculus obstruction | Use when a ureteral stone causes hydronephrosis. |
|
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 ureteral stone
Essential facts and insights about Ureteral Stone
Primary ICD-10-CM Codes for ureteral stone
Decision Criteria
clinical Criteria
- Presence of ureteral stone on imaging
documentation Criteria
- Document laterality and size of stone
Applicable To
- Ureteral stone
Excludes
- Hydronephrosis with calculus obstruction (N13.2)
Clinical Validation Requirements
- Imaging confirmation of ureteral stone
- Symptoms such as flank pain
Code-Specific Risks
- Ensure laterality is documented
- Avoid using if hydronephrosis is present
Coding Notes
- Ensure imaging confirms the presence and location of the stone.
N13.2 - Hydronephrosis with calculus obstruction
Use when a ureteral stone causes hydronephrosis.
Applicable To
- Obstructive uropathy due to ureteral stone
Excludes
- Calculus of ureter without hydronephrosis (N20.1)
Clinical Validation Requirements
- Imaging showing hydronephrosis
- Documentation of obstruction severity
Coding Notes
Hydronephrosis must be documented as secondary to the stone.
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 Ureteral Stone to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N20.1.
Impact
Clinical: Inadequate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Use standardized templates, Educate staff on documentation requirements
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Always document and code the laterality of the stone.
Impact
Missing details on stone size and location can lead to audit issues.
Mitigation Strategy
Implement thorough documentation practices and regular audits.
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 Ureteral Stone, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ureteral Stone
Use these documentation templates to ensure complete and accurate documentation for Ureteral Stone. These templates include all required elements for proper coding and billing.
Ureteral stone with hydronephrosis
Specialty: UrologyRequired Elements
- Patient symptoms
- Imaging results
- Stone size and location
- Presence of hydronephrosis
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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