2025 ICD-10-CM code N21.1
(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 urethra.
Modifiers may be applicable depending on the circumstances of the procedure used to remove the stone.Consult the appropriate modifier guidelines for specific scenarios.
Medical necessity for treatment of urethral calculi is established when symptoms such as pain, urinary obstruction, or urinary tract infections are present.The size and location of the stone may necessitate different treatment options, and documentation should justify the chosen intervention based on the patient's clinical presentation.
Urologists and other healthcare professionals specializing in urinary tract conditions are responsible for diagnosing and treating urethral calculi.The clinical responsibility may involve conducting physical examinations, ordering imaging studies (such as X-rays or CT scans), and determining the appropriate treatment strategy (e.g., medical expulsive therapy, urethroscopy, surgery).
In simple words: This code means there's a kidney stone in the urethra, the tube that carries urine out of your body. This can cause pain when urinating and other urinary problems.
N21.1, Calculus in urethra, refers to the presence of a stone (calculus) within the urethra, the tube that carries urine from the bladder to the outside of the body.This condition can cause pain, difficulty urinating, and urinary tract infections. The size and location of the stone within the urethra will determine the severity of symptoms and the required treatment.
Example 1: A 60-year-old male patient presents with severe pain during urination and difficulty voiding.A physical examination reveals tenderness in the urethra.Imaging studies confirm the presence of a small urethral calculus. The patient undergoes urethroscopy to remove the stone., A 35-year-old female patient reports intermittent pain and burning during urination.A urinalysis shows signs of infection, and imaging studies identify a larger urethral stone obstructing urine flow.The patient receives antibiotics to manage the infection and undergoes a surgical procedure to remove the calculus., A 72-year-old male patient with a history of recurrent urinary tract infections and known kidney stones is admitted to the hospital with acute urinary retention. A CT scan shows a large urethral stone causing complete blockage.Urgent surgical intervention is required to relieve the obstruction and prevent further complications.
Complete medical history, physical examination findings, urinalysis results, imaging studies (e.g., X-ray, CT scan, ultrasound) demonstrating the presence and location of the calculus within the urethra, details of any procedures performed to remove the stone, and post-procedure assessments.
** This code should be used only when the calculus is specifically located in the urethra.If the calculus is located in other parts of the urinary tract, a different code should be used.
- Payment Status: Active
- Specialties:Urology
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Ambulatory Surgical Center