2025 ICD-10-CM code N13.73
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Renal tubulo-interstitial diseases - Vesicoureteral reflux Diseases of the genitourinary system (N00-N99) Feed
Vesicoureteral reflux with reflux nephropathy and hydroureter.
Modifiers may be applicable depending on the specific circumstances of the encounter and the services provided.Consult the official modifier guidelines for more information.
Medical necessity is established by the presence of symptoms consistent with VUR, supporting imaging findings, and documentation of reflux nephropathy or hydroureter. The severity of the condition and its potential to cause further damage to the kidneys would justify diagnostic and/or therapeutic interventions.
Urologist, nephrologist
In simple words: This code describes a condition where urine flows backward from the bladder to the kidneys, causing damage to the kidneys and swelling of the tubes connecting the kidneys to the bladder.
This code signifies vesicoureteral reflux (VUR), a condition where urine flows backward from the bladder to the ureters and kidneys.It's further specified as including reflux nephropathy (damage to the kidneys due to reflux) and hydroureter (dilation of the ureter due to urine backup).
Example 1: A 2-year-old child presents with recurrent urinary tract infections (UTIs).Imaging studies reveal bilateral vesicoureteral reflux with evidence of reflux nephropathy and hydroureter. Code N13.73 is used to bill for this diagnosis., A 10-year-old child undergoes a voiding cystourethrogram (VCUG) that shows significant vesicoureteral reflux with mild hydronephrosis on one side.Renal ultrasound reveals early signs of reflux nephropathy. Code N13.73 is appropriate., An adult patient with a history of recurrent UTIs has a diagnostic workup demonstrating severe bilateral VUR with significant reflux nephropathy and bilateral hydroureter.This complex case is coded using N13.73.
Detailed medical history including symptoms (frequency, urgency, dysuria, flank pain), results of physical examination, urinalysis, urine culture, imaging studies (ultrasound, VCUG, CT scan), and any previous treatment.Relevant laboratory values such as serum creatinine and BUN may also be needed.
** This code requires careful consideration of the clinical picture and imaging findings to accurately reflect the severity and extent of the disease.Differentiation from other related codes is crucial.
- Payment Status: Active
- Specialties:Urology, Nephrology, Pediatric Urology
- Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center