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2025 ICD-10-CM code N30.81

Other cystitis with hematuria.

Use additional code to identify infectious agent (B95-B97) if known.

Medical necessity depends on establishing a clear link between the diagnosis of cystitis with hematuria and the patient's clinical presentation. The documentation should support the need for medical intervention, such as antibiotic treatment or other management strategies, based on the patient's symptoms, the presence of blood in the urine, and the potential for complications.

Diagnosis and treatment of this condition falls under the purview of physicians specializing in urology or nephrology, and potentially primary care providers depending on the clinical scenario and setting.

In simple words: This code indicates a bladder infection or inflammation (cystitis) that is not specifically categorized elsewhere, and it's accompanied by blood in the urine (hematuria).

Other cystitis with hematuria. This code excludes prostatocystitis (N41.3). An additional code should be used to identify the infectious agent (B95-B97), if applicable.

Example 1: A 45-year-old female patient presents with painful urination, increased frequency, and blood in her urine. After ruling out other causes, she is diagnosed with other cystitis with hematuria (N30.81)., A 60-year-old male patient undergoing radiation therapy for prostate cancer experiences frequent urination and blood in his urine. He is subsequently diagnosed with radiation-induced cystitis with hematuria (N30.81, with an additional code to specify the underlying cause of the radiation)., A 25-year-old female patient with a history of recurrent urinary tract infections reports painful urination and visible blood in her urine. Following examination and urinalysis, she receives a diagnosis of other cystitis with hematuria (N30.81). Further investigation reveals no specific cause, and she is treated with antibiotics and advised on preventive measures.

Documentation should include detailed patient history, presenting symptoms, physical examination findings, urinalysis results (including the presence of blood), and any additional diagnostic tests performed (e.g., urine culture) to confirm the diagnosis and rule out other conditions.  If a specific cause (such as radiation) is identified, this should also be clearly documented.It's also essential to include information about symptom duration, severity, and associated symptoms.

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