2025 ICD-10-CM code N20.2
(Active) Effective Date: N/A Revision Date: N/A Genitourinary - Urolithiasis XIV Diseases of the genitourinary system Feed
Calculus of kidney with calculus of ureter.
Modifiers may be needed to indicate laterality (left or right), multiple procedures, or other specific circumstances according to procedural coding.
Medical necessity for diagnosis and treatment of kidney and ureteral stones is established based on the presence of symptoms such as severe flank pain (renal colic), hematuria, urinary tract infection, hydronephrosis (if present), or impaired renal function.The severity of symptoms and potential complications (obstruction, infection) dictate the need for intervention.
Diagnosis and management of kidney and ureteral stones. This may involve imaging studies (ultrasound, CT scan), and potentially intervention such as ureteroscopic stone removal or extracorporeal shock wave lithotripsy (ESWL).
In simple words: This code means that there are stones in both the kidney and the tube that connects the kidney to the bladder (ureter).This usually causes pain in the side or back, and sometimes blood in the urine.
This code signifies the presence of kidney stones (nephrolithiasis) in conjunction with stones in the ureter (ureteric calculi).It indicates a simultaneous occurrence of calculi in both the kidney and the ureter. This condition often presents with symptoms such as flank pain (renal colic), hematuria (blood in the urine), and potential urinary tract infection.
Example 1: A 55-year-old male presents with severe flank pain radiating to the groin, accompanied by nausea, vomiting, and microscopic hematuria. Imaging reveals a large staghorn calculus in the right kidney and a smaller stone obstructing the right ureter., A 30-year-old female reports intermittent right flank pain and urgency.A non-contrast CT scan demonstrates multiple small calculi within the right kidney and a single stone lodged in the distal right ureter., A 70-year-old male with a history of hyperparathyroidism experiences severe left flank pain and is found to have a large stone obstructing the left ureter and several smaller stones in the left kidney.The patient is admitted for management.
Detailed patient history including pain characteristics, duration, and associated symptoms.Imaging studies (ultrasound, CT scan, KUB) demonstrating location and size of the calculi.Laboratory results, including urinalysis (microscopic hematuria) and blood chemistry (creatinine, BUN). Documentation of any interventions (ESWL, ureteroscopy).
** This code is used for billing purposes and reflects the presence of kidney and ureteral stones.The treatment and management will vary based on individual patient factors and severity.Consult with a qualified medical coder for appropriate coding and billing practices.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Urology, Nephrology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office, Emergency Room - Hospital, Ambulatory Surgical Center