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v1.0.0
ICD-10 Guide
ICD-10 CodesN28.86

N28.86

Billable

Ureteritis cystica

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

Code Description

ICD-10 N28.86 is a billable code used to indicate a diagnosis of ureteritis cystica.

Key Diagnostic Point:

Ureteritis cystica is a benign condition characterized by the formation of cystic lesions in the ureteral mucosa. It is often associated with chronic irritation or inflammation of the ureter, which can result from various factors such as urinary tract infections, calculi, or other irritants. The condition is typically asymptomatic but may present with symptoms such as hematuria, dysuria, or flank pain in some cases. Diagnosis is usually made through imaging studies, such as ultrasound or CT scans, which may reveal the presence of cystic structures. Ureteritis cystica is not classified under other specific categories of ureteral or kidney disorders, making it a unique entity in the ICD-10 coding system. Treatment is generally conservative, focusing on addressing the underlying cause of irritation or inflammation, and surgical intervention is rarely required unless complications arise. Understanding this condition is crucial for accurate coding and appropriate management in clinical practice.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other ureteral conditions
  • Need for precise documentation of symptoms
  • Potential overlap with other urinary tract disorders
  • Variability in clinical presentation

Audit Risk Factors

  • Inadequate documentation of symptoms
  • Failure to specify the underlying cause of irritation
  • Misclassification with more severe ureteral disorders
  • Lack of imaging study documentation

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed clinical notes on symptoms, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with hematuria or flank pain, requiring imaging to rule out other conditions.

Billing Considerations

Ensure that all relevant diagnostic tests are documented to support the diagnosis of ureteritis cystica.

Radiology

Documentation Requirements

Clear imaging reports indicating the presence of cystic lesions in the ureter.

Common Clinical Scenarios

Imaging studies performed for patients with suspected urinary tract issues.

Billing Considerations

Radiologists should provide detailed descriptions of findings to aid in accurate coding.

Coding Guidelines

Inclusion Criteria

Use N28.86 When
  • According to ICD
  • 10 guidelines, N28
  • 86 should be used when ureteritis cystica is diagnosed and documented
  • It is important to ensure that the diagnosis is not included in other specified categories of kidney or ureter disorders

Exclusion Criteria

Do NOT use N28.86 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76700CPT Code

Ultrasound, abdomen, complete

Clinical Scenario

Used to evaluate for cystic lesions in the ureter.

Documentation Requirements

Document findings and indications for the ultrasound.

Specialty Considerations

Urologists should ensure imaging correlates with clinical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of ureteritis cystica, improving the accuracy of diagnoses and treatment plans.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of ureteritis cystica, improving the accuracy of diagnoses and treatment plans.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of ureteritis cystica, improving the accuracy of diagnoses and treatment plans.

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 are the common symptoms of ureteritis cystica?

Common symptoms may include hematuria, dysuria, and flank pain, although many patients may be asymptomatic.