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ICD-10 Guide
ICD-10 CodesN20.2

N20.2

Billable

Calculus of kidney with calculus of ureter

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/18/2025

Code Description

ICD-10 N20.2 is a billable code used to indicate a diagnosis of calculus of kidney with calculus of ureter.

Key Diagnostic Point:

N20.2 refers to the presence of calculi (stones) in both the kidney and ureter, a condition commonly known as urolithiasis. Kidney stones are hard deposits made of minerals and salts that form inside the kidneys, while ureteral calculi are stones that have moved from the kidney into the ureter, the tube connecting the kidney to the bladder. Symptoms may include severe pain (often referred to as renal colic), hematuria (blood in urine), and urinary obstruction. Diagnosis typically involves imaging studies such as ultrasound or CT scans. Treatment options vary based on the size and location of the stones and may include conservative management, lithotripsy (a procedure that uses shock waves to break up stones), or surgical interventions such as ureteroscopy or percutaneous nephrolithotomy. Dietary modifications, such as increased fluid intake and dietary adjustments to reduce oxalate, calcium, or uric acid intake, may also be recommended to prevent recurrence.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between kidney and ureteral stones
  • Understanding the severity and symptoms associated with the condition
  • Variability in treatment options and their documentation
  • Potential for co-existing conditions that may complicate coding

Audit Risk Factors

  • Inadequate documentation of imaging studies
  • Failure to document the size and location of stones
  • Lack of clarity on treatment modalities used
  • Misclassification of the type of calculus

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed documentation of stone size, location, and treatment plan.

Common Clinical Scenarios

Patients presenting with renal colic, hematuria, or urinary obstruction due to stones.

Billing Considerations

Ensure all imaging and treatment procedures are documented clearly to support coding.

Radiology

Documentation Requirements

Clear imaging reports indicating the presence and location of calculi.

Common Clinical Scenarios

Imaging studies performed for suspected urolithiasis.

Billing Considerations

Accurate reporting of findings is crucial for proper coding and billing.

Coding Guidelines

Inclusion Criteria

Use N20.2 When
  • Follow official coding guidelines for urolithiasis, ensuring accurate documentation of the condition's severity and treatment
  • Include any relevant imaging studies and treatment modalities in the patient's medical record

Exclusion Criteria

Do NOT use N20.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

50590CPT Code

Lithotripsy, extracorporeal shock wave

Clinical Scenario

Used for patients with calculi in the kidney or ureter.

Documentation Requirements

Document the size and location of stones treated.

Specialty Considerations

Urology specialists should ensure all procedural details are captured.

52332CPT Code

Ureteroscopy with stone removal

Clinical Scenario

Indicated for larger stones obstructing the ureter.

Documentation Requirements

Document findings and any complications during the procedure.

Specialty Considerations

Urologists must provide detailed operative reports.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of urolithiasis, improving the accuracy of data collection and reimbursement processes. N20.2 provides a clear distinction between kidney and ureteral stones, which is essential for treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of urolithiasis, improving the accuracy of data collection and reimbursement processes. N20.2 provides a clear distinction between kidney and ureteral stones, which is essential for treatment planning.

Reimbursement & Billing Impact

reimbursement processes. N20.2 provides a clear distinction between kidney and ureteral stones, which is essential for treatment planning.

Resources

Clinical References

  • •
    American Urological Association Guidelines

Coding & Billing References

  • •
    American Urological Association Guidelines

Frequently Asked Questions

What are the common symptoms of N20.2?

Common symptoms include severe flank pain, hematuria, and urinary obstruction. Patients may also experience nausea and vomiting.

How is N20.2 treated?

Treatment options include conservative management with hydration, lithotripsy, ureteroscopy, or surgical removal depending on the size and location of the stones.