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v1.0.0
ICD-10 Guide
ICD-10 CodesN30.81

N30.81

Billable

Other cystitis with hematuria

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

Code Description

ICD-10 N30.81 is a billable code used to indicate a diagnosis of other cystitis with hematuria.

Key Diagnostic Point:

N30.81 refers to a specific type of cystitis characterized by inflammation of the bladder, accompanied by hematuria, which is the presence of blood in the urine. This condition can arise from various etiologies, including infections, chemical irritants, or underlying medical conditions such as interstitial cystitis or radiation cystitis. Patients may present with symptoms such as dysuria (painful urination), increased urinary frequency, urgency, and lower abdominal discomfort. Hematuria can be gross (visible to the naked eye) or microscopic, and its presence often necessitates further investigation to rule out more serious conditions such as malignancies or urolithiasis. The management of cystitis with hematuria typically involves addressing the underlying cause, which may include antibiotics for infections, bladder instillations, or other therapeutic interventions. Accurate coding is essential for appropriate treatment and reimbursement, as well as for tracking epidemiological trends in bladder disorders.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of cystitis (e.g., infectious vs. non-infectious)
  • Identifying the presence and type of hematuria
  • Understanding the patient's complete medical history and comorbidities
  • Documenting symptoms accurately to support the diagnosis

Audit Risk Factors

  • Inadequate documentation of hematuria
  • Failure to specify the type of cystitis
  • Lack of supporting clinical evidence for the diagnosis
  • Misclassification of cystitis type

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed patient history, physical examination findings, and results of urinalysis and imaging studies.

Common Clinical Scenarios

Patients presenting with recurrent urinary tract infections, hematuria, or bladder pain.

Billing Considerations

Urologists must ensure that all relevant diagnostic tests are documented to support the diagnosis of cystitis with hematuria.

Primary Care

Documentation Requirements

Comprehensive documentation of symptoms, duration, and any prior treatments or interventions.

Common Clinical Scenarios

Patients with acute onset of dysuria and hematuria, often referred to urology for further evaluation.

Billing Considerations

Primary care providers should document any relevant risk factors, such as recent antibiotic use or urinary catheterization.

Coding Guidelines

Inclusion Criteria

Use N30.81 When
  • According to ICD
  • 10 coding guidelines, N30
  • 81 should be used when cystitis is confirmed with hematuria
  • It is important to document the cause of cystitis if known, as this may affect treatment and coding

Exclusion Criteria

Do NOT use N30.81 When
  • Exclusion criteria include cystitis due to specific infectious agents or other specified conditions

Related ICD-10 Codes

Related CPT Codes

52000CPT Code

Cystoscopy

Clinical Scenario

Used when evaluating hematuria in patients with suspected cystitis.

Documentation Requirements

Document indication for cystoscopy and findings.

Specialty Considerations

Urologists should ensure that the procedure is justified based on clinical symptoms.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of cystitis types, improving the accuracy of diagnoses and treatment tracking. N30.81 provides a distinct code for cystitis with hematuria, enhancing clinical data quality.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cystitis types, improving the accuracy of diagnoses and treatment tracking. N30.81 provides a distinct code for cystitis with hematuria, enhancing clinical data quality.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of cystitis types, improving the accuracy of diagnoses and treatment tracking. N30.81 provides a distinct code for cystitis with hematuria, enhancing clinical data quality.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between N30.81 and N30.00?

N30.81 is used for cystitis with hematuria, while N30.00 is for acute cystitis without hematuria. The presence of hematuria indicates a need for further evaluation and may suggest more serious underlying conditions.