2025 ICD-10-CM code N20.0
(Active) Effective Date: N/A Diseases of the genitourinary system - Urolithiasis XIV Feed
Calculus of kidney. Nephrolithiasis NOS. Renal calculus.
No specific modifiers apply to ICD-10-CM codes.
Medical necessity for treatment of a kidney stone is established by documentation of symptoms (e.g., pain, obstruction, infection), the size and location of the stone, and the potential for complications if left untreated.
The clinical responsibility for N20.0 lies with the physician providing care for the patient with the kidney stone. This may include a primary care physician, a urologist, or a nephrologist, depending on the severity and complexity of the case. Responsibilities include diagnosis, treatment planning (which might involve medical management, lithotripsy, or surgical intervention), post-procedure care, and monitoring for recurrence.
In simple words: Kidney stone
Calculus of kidney. Nephrolithiasis NOS. Renal calculus. Renal stone. Staghorn calculus. Stone in kidney.
Example 1: A 45-year-old male presents to the emergency department with severe right flank pain radiating to the groin. Imaging studies reveal a 5mm calculus in the right kidney. Diagnosis: N20.0., A 60-year-old female with a history of recurrent urinary tract infections undergoes a CT scan, incidentally revealing a small, asymptomatic renal calculus. Diagnosis: N20.0., A 30-year-old male experiences sudden onset of left flank pain while exercising. A subsequent ultrasound shows a large staghorn calculus in the left kidney. Diagnosis: N20.0.
Documentation should include the location and size of the stone, the presence or absence of obstruction, associated symptoms (e.g., pain, hematuria, nausea, vomiting), and any relevant medical history (e.g., prior stones, family history of stones). Imaging reports confirming the presence and location of the calculus are essential.
** Excludes1: nephrocalcinosis (E83.59) and hydronephrosis caused by the stone (N13.2).For accurate coding, refer to the official ICD-10-CM coding guidelines and iFrameAI if needed.
- Payment Status: Active
- Specialties:Urology, Nephrology, Primary Care
- Place of Service:Inpatient Hospital, Emergency Room - Hospital, Office, Outpatient Hospital, Ambulatory Surgical Center, and other places of service depending on the clinical scenario and provided services.