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2025 ICD-10-CM code N32.1

Vesicointestinal fistula; abnormal connection between the bladder and intestine.

Appropriate coding requires accurate identification of the location of the fistula and any associated complications.Ensure proper documentation to support the diagnosis and chosen treatment modality.

Medical necessity for the treatment of a vesicointestinal fistula is established by the presence of symptoms such as urinary tract infections, fecaluria, pneumaturia, and abdominal pain, along with the confirmation of the fistula through appropriate imaging studies. The need for surgical intervention is determined by the severity of symptoms and the potential complications of the fistula.

Urologists and surgeons are primarily responsible for the diagnosis and management of vesicointestinal fistulas.Depending on the cause and complexity of the fistula, other specialists such as gastroenterologists or colorectal surgeons may be involved.

IMPORTANT:ICD-9-CM code 596.1 (Intestinovesical fistula) is the equivalent code.

In simple words: A vesicointestinal fistula is an unusual connection between the bladder and the intestines. This allows urine and/or bowel contents to leak between these areas, leading to potential medical problems.

Vesicointestinal fistula (N32.1) is an abnormal connection between the urinary bladder and the intestine.This can result in the passage of urine into the intestines or vice versa, leading to various complications.The fistula may be between the bladder and the rectum (vesicorectal fistula) or other parts of the intestine.The cause can be diverse, including diverticulitis, pelvic surgery, inflammatory bowel disease, radiation therapy, and tumors.

Example 1: A patient presents with recurrent urinary tract infections and fecaluria (feces in the urine). Imaging studies reveal a vesicocolic fistula, a connection between the bladder and the colon.The patient undergoes surgical repair., A patient who underwent a pelvic resection for rectal cancer develops a vesicorectal fistula postoperatively.This is detected through cystoscopy and subsequent imaging.The patient is managed conservatively initially, with attempts at fistula closure., A patient with Crohn's disease has recurrent urinary tract symptoms and unexplained pneumaturia (air in the urine).Imaging demonstrates a vesicosigmoid fistula.This necessitates collaborative management with a gastroenterologist and a urologist.

Detailed history and physical examination, including symptoms such as urinary tract infections, pneumaturia, fecaluria, and abdominal pain.Imaging studies such as cystography, colonoscopy, computed tomography (CT), and magnetic resonance imaging (MRI) are crucial for diagnosis and localization.Operative reports, pathology reports (if surgery is performed), and any relevant laboratory results are necessary for complete documentation.

** Vesicointestinal fistulas are complex conditions requiring multidisciplinary care.Accurate coding depends on the comprehensive documentation of the patient's history, examination findings, and imaging results.

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