2025 ICD-10-CM code N20
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the genitourinary system - Urolithiasis Diseases of the genitourinary system Feed
Calculus of kidney and ureter.
Modifiers may be applicable depending on the circumstances of the encounter and the services provided.
Medical necessity is established by the presence of symptoms consistent with urolithiasis and confirmed by appropriate imaging studies.Treatment may be required to alleviate symptoms and prevent complications such as obstruction or infection.
Urologist, nephrologist, or other physician managing urinary tract issues.
In simple words: Kidney stones or stones in the tube connecting the kidney to the bladder (ureter).
This code encompasses the presence of calculi (stones) in either the kidney or ureter.It includes conditions such as kidney stones and ureteral stones.The code does not include nephrocalcinosis (E83.59) with or without hydronephrosis (N13.2).
Example 1: A 45-year-old male presents with severe flank pain radiating to the groin, nausea, and hematuria. Imaging reveals a 1 cm calculus in the right ureter. Code N20.1 is assigned., A 60-year-old female with a history of hyperparathyroidism reports intermittent flank pain.Ultrasound reveals multiple small calculi in the left kidney. Code N20.0 is assigned., A 30-year-old male presents with acute onset of excruciating flank pain, with a CT scan revealing a large staghorn calculus filling the renal pelvis.Code N20 is assigned.
Complete history and physical exam; imaging studies (ultrasound, CT scan, KUB); urinalysis; laboratory data (serum creatinine, electrolytes); documentation of symptoms (pain, hematuria); treatment notes.
** This code should be used cautiously, with careful consideration of the excludes1 notes to avoid inappropriate coding.Always utilize the most specific code possible based on available documentation.The use of this code can influence reimbursement and should be done accurately.
- Payment Status: Active
- Specialties:Urology, Nephrology
- Place of Service:Office, Hospital (Inpatient and Outpatient), Urgent Care, Emergency Room