2025 ICD-10-CM code N21.0
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the genitourinary system - Urolithiasis (N20-N23) Diseases of the genitourinary system (N00-N99) Feed
Calculus in the bladder; urinary bladder stone.
Modifiers may apply depending on the circumstances of the encounter and procedures performed.Consult the official coding guidelines and payer-specific instructions for applicable modifiers.
Medical necessity is established by the presence of symptoms attributable to the bladder stone (e.g., urinary obstruction, infection, pain, hematuria), necessitating diagnostic and/or therapeutic intervention.Asymptomatic stones may not require immediate intervention.
Urologist, nephrologist, or other relevant specialist.
In simple words: This code means a stone is found in the bladder.It doesn't include kidney stones that have spread into the bladder (staghorn calculi).
This code signifies the presence of a calculus (stone) within the urinary bladder.It includes calculi located in a diverticulum of the bladder.This code excludes staghorn calculi (N20.0).
Example 1: A 60-year-old male presents with urinary frequency, urgency, and dysuria. Imaging reveals a single, 1cm bladder stone.The stone is removed via cystoscopy., A 75-year-old female with a history of urinary tract infections experiences recurrent episodes of hematuria and severe bladder pain.A bladder stone is identified during cystoscopy and removed using a lithotripter., A 45-year-old male undergoes a routine physical exam.An incidental bladder stone is discovered during ultrasound imaging.Further evaluation determines the stone is small and asymptomatic. Conservative management with increased fluid intake is recommended.
Detailed history and physical examination findings including symptoms, imaging reports (e.g., KUB x-ray, CT scan, ultrasound), operative reports (if applicable), and pathology results (if applicable).
** Always confirm the specificity of the bladder stone's location and characteristics.If the stone is in a diverticulum, the code remains appropriate.If the stone is a staghorn calculus, N20.0 should be used instead.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Urology, Nephrology
- Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center, Emergency Room