2025 ICD-10-CM code N13.729
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the genitourinary system - Renal tubulo-interstitial diseases Diseases of the genitourinary system (N00-N99) Feed
Vesicoureteral reflux with reflux nephropathy without hydroureter, unspecified.
Medical necessity for coding N13.729 is established by the presence of vesicoureteral reflux causing reflux nephropathy and confirmed by appropriate clinical and radiological findings.The severity of the reflux and any associated symptoms (e.g., recurrent UTIs, kidney damage) justify the diagnosis and support medical necessity.
The clinical responsibility for this code would involve a urologist or nephrologist.The physician would be responsible for diagnosis (possibly through imaging studies like ultrasound or voiding cystourethrogram), assessment of kidney function (e.g., blood tests, urine tests), and determination of the need for treatment or follow-up. Treatment options may range from observation and antibiotic prophylaxis to surgical interventions.
In simple words: This code describes a condition where urine flows backward from the bladder to the kidneys, causing kidney damage.The specific details of the damage are not known.
This code classifies vesicoureteral reflux (VUR) with associated reflux nephropathy, but without hydroureter.Reflux nephropathy refers to kidney damage caused by the backflow of urine from the bladder into the ureters and kidneys.The unspecified nature indicates that further details regarding the severity or specific characteristics of the condition are not available or not specified in the documentation.
Example 1: A 5-year-old child presents with recurrent urinary tract infections (UTIs).A voiding cystourethrogram (VCUG) reveals bilateral vesicoureteral reflux (VUR).Renal ultrasound shows mild scarring consistent with reflux nephropathy. The physician documents N13.729., A 10-year-old presents with a history of UTIs and elevated creatinine levels.Imaging studies confirm VUR and reflux nephropathy. The physician notes that there is no evidence of hydroureter. N13.729 is selected., An adult with a history of VUR and UTIs undergoes imaging that reveals minimal scarring, indicative of reflux nephropathy without hydroureter.The clinician selects N13.729.
Detailed clinical history including frequency and severity of UTIs, results of renal function tests (e.g., creatinine, BUN, GFR), imaging studies such as VCUG, renal ultrasound, and any other relevant diagnostic information.Treatment plan and response to treatment should also be documented.
** This code is highly specific and requires careful review of clinical documentation to confirm the absence of hydroureter and the presence of reflux nephropathy.Always refer to the most up-to-date coding guidelines from the Centers for Medicare & Medicaid Services (CMS).
- Payment Status: Active
- Specialties:Urology, Nephrology, Pediatrics
- Place of Service:Office, Hospital (Inpatient and Outpatient), Clinic