2025 ICD-10-CM code N13.7
Vesicoureteral reflux. This condition is when urine flows backward from the bladder into the ureters and sometimes the kidneys.
Medical necessity for services related to vesicoureteral reflux is established by the presence of signs, symptoms, or diagnostic findings consistent with the condition.The severity of the reflux and the presence of complications such as recurrent urinary tract infections or kidney damage also contribute to determining medical necessity.
Diagnosis and management of vesicoureteral reflux typically falls under the purview of urologists and nephrologists.They are responsible for evaluating the patient's condition, determining the severity of the reflux, and recommending the appropriate course of treatment, which may include medical management, endoscopic procedures, or surgery.
- 14 Diseases of the genitourinary system (N00-N99)
- N13 Obstructive and reflux uropathyN13.7 Vesicoureteral reflux
In simple words: This code describes a condition where urine flows backward from the bladder up into the tubes that connect the kidneys to the bladder (ureters), and sometimes even back into the kidneys.
Vesicoureteral reflux is the retrograde flow of urine from the bladder into the ureters and potentially into the kidneys.
Example 1: A 2-year-old child presents with recurrent urinary tract infections. A voiding cystourethrogram (VCUG) reveals grade III vesicoureteral reflux. The child is started on prophylactic antibiotics and monitored regularly., A 35-year-old woman experiences flank pain and fever. Diagnostic imaging shows hydronephrosis and vesicoureteral reflux.She undergoes ureteral reimplantation surgery to correct the reflux., A 10-year-old child with a history of vesicoureteral reflux is being followed by a nephrologist.Yearly VCUGs show improvement in the reflux, and the patient eventually discontinues prophylactic antibiotics.
Documentation for vesicoureteral reflux should include details of the diagnostic testing performed (e.g., VCUG, renal ultrasound), the grade of reflux (if applicable), the presence of any associated conditions (e.g., urinary tract infections, hydronephrosis), and the treatment plan.
- Payment Status: Active
- Specialties:Urology, Nephrology, Pediatrics
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Office