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ICD-10 Guide
ICD-10 CodesN13.73

N13.73

Billable

Vesicoureteral-reflux with reflux nephropathy with hydroureter

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

Code Description

ICD-10 N13.73 is a billable code used to indicate a diagnosis of vesicoureteral-reflux with reflux nephropathy with hydroureter.

Key Diagnostic Point:

Vesicoureteral reflux (VUR) is a condition where urine flows backward from the bladder into the ureters and potentially the kidneys. This abnormal flow can lead to recurrent urinary tract infections (UTIs) and subsequent kidney damage, known as reflux nephropathy. In cases where VUR is severe, it can cause hydroureter, which is the dilation of the ureter due to obstruction or increased pressure from the refluxing urine. The combination of VUR and reflux nephropathy can lead to pyelonephritis, an infection of the kidney, and interstitial nephritis, which is inflammation of the kidney's interstitial tissue. Patients may present with symptoms such as flank pain, fever, and dysuria. Management often includes antibiotic therapy to prevent UTIs, and in some cases, surgical intervention may be necessary to correct the reflux. The condition requires careful monitoring and management to prevent long-term renal damage.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Multiple conditions involved (VUR, reflux nephropathy, hydroureter)
  • Need for precise documentation of symptoms and treatment
  • Potential for overlapping diagnoses (e.g., pyelonephritis)
  • Variability in clinical presentation and severity

Audit Risk Factors

  • Inadequate documentation of the severity of reflux
  • Failure to document recurrent UTIs
  • Lack of clarity on the relationship between VUR and nephropathy
  • Inconsistent coding of associated conditions

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed notes on the patient's history of UTIs, imaging studies, and any surgical interventions.

Common Clinical Scenarios

Evaluation of pediatric patients with recurrent UTIs, management of VUR, and surgical correction.

Billing Considerations

Ensure clear documentation of the degree of reflux and any associated renal damage.

Nephrology

Documentation Requirements

Comprehensive renal function assessments, lab results, and treatment plans for nephropathy.

Common Clinical Scenarios

Management of chronic kidney disease secondary to reflux nephropathy.

Billing Considerations

Document the impact of VUR on renal function and any interventions undertaken.

Coding Guidelines

Inclusion Criteria

Use N13.73 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of all components of the diagnosis
  • Include details on the severity of reflux and any associated complications
  • Ensure that the code reflects the most specific diagnosis available

Exclusion Criteria

Do NOT use N13.73 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

52332CPT Code

Cystourethroscopy with injection of bulking agent

Clinical Scenario

Used in the treatment of VUR to prevent reflux.

Documentation Requirements

Document the indication for the procedure and any pre-operative evaluations.

Specialty Considerations

Urology specialists should ensure that the procedure is linked to the diagnosis of VUR.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 allows for more specific coding of conditions like vesicoureteral reflux, improving the accuracy of patient records and facilitating better management of complex cases.

ICD-9 vs ICD-10

The transition to ICD-10 allows for more specific coding of conditions like vesicoureteral reflux, improving the accuracy of patient records and facilitating better management of complex cases.

Reimbursement & Billing Impact

The transition to ICD-10 allows for more specific coding of conditions like vesicoureteral reflux, improving the accuracy of patient records and facilitating better management of complex cases.

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 significance of coding N13.73 accurately?

Accurate coding of N13.73 is crucial for proper reimbursement, quality of care, and tracking of patient outcomes related to vesicoureteral reflux and its complications.