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2025 ICD-10-CM code N11.1

Chronic obstructive pyelonephritis.

Use additional code (B95-B97) to identify the infectious agent. Do not use this code for calculous pyelonephritis (N20.9) or obstructive uropathy (N13.-).

Medical necessity for treatment of chronic obstructive pyelonephritis is established by the presence of chronic pyogenic kidney infection due to anatomic abnormalities causing obstruction. Documentation should link the infection and obstruction and support the need for intervention to prevent further renal damage.

The physician is responsible for diagnosing and treating chronic obstructive pyelonephritis, which includes ordering appropriate imaging studies, such as ultrasonography, CT scan, or intravenous urography (IVU), and urinalysis with urine culture.Treatment involves antibiotics and correction of any underlying structural disorders causing the obstruction.

In simple words: A long-term kidney infection caused by blockage in the urinary tract.

Chronic pyelonephritis associated with an obstruction in the urinary tract.

Example 1: A 45-year-old male presents with recurrent urinary tract infections and flank pain. Imaging reveals a large cortical scar on the upper pole of the kidney, along with ureteral dilation, indicative of chronic obstructive pyelonephritis., A child with a history of vesicoureteral reflux (VUR) experiences frequent UTIs.Imaging reveals scarring and thinning of the renal parenchyma, leading to a diagnosis of chronic obstructive pyelonephritis., An elderly patient undergoing an abdominal ultrasound for unrelated reasons is incidentally found to have a blunted calyx and cortical scarring in the kidney. Urinalysis shows evidence of infection, and further workup confirms chronic obstructive pyelonephritis.

Documentation should include relevant history of UTIs, physical examination findings, urinalysis and urine culture results, and imaging studies (e.g., ultrasound, CT, IVU) demonstrating characteristic renal scarring and any obstruction. The specific type of obstruction (e.g., stricture, kinking of ureter, crossing vessel) should also be documented.

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