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v1.0.0
ICD-10 Guide
ICD-10 CodesN35.116

N35.116

Billable

Postinfective urethral stricture, not elsewhere classified, male, overlapping sites

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

Code Description

ICD-10 N35.116 is a billable code used to indicate a diagnosis of postinfective urethral stricture, not elsewhere classified, male, overlapping sites.

Key Diagnostic Point:

Postinfective urethral stricture refers to a narrowing of the urethra that occurs as a result of a previous infection, often leading to urinary obstruction and other complications. This condition is particularly prevalent in males and can arise from various infectious agents, including sexually transmitted infections (STIs) such as gonorrhea or chlamydia, as well as non-STI-related infections. The stricture can occur at multiple sites along the urethra, complicating diagnosis and treatment. Symptoms may include difficulty urinating, weak urine stream, and recurrent urinary tract infections (UTIs). Diagnosis typically involves a combination of patient history, physical examination, and imaging studies such as retrograde urethrograms. Treatment options may include urethral dilation, urethrotomy, or surgical reconstruction, depending on the severity and location of the stricture. Accurate coding is essential for proper management and reimbursement, as well as for tracking the incidence of this condition in the population.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of overlapping sites in the urethra.
  • Differentiation from other types of urethral strictures.
  • Need for detailed documentation of prior infections.
  • Potential for multiple codes to be applicable based on patient history.

Audit Risk Factors

  • Inadequate documentation of prior infections.
  • Failure to specify overlapping sites.
  • Misclassification of stricture type.
  • Inconsistent coding practices across providers.

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed history of urinary symptoms, prior infections, and imaging results.

Common Clinical Scenarios

Patients presenting with urinary obstruction, recurrent UTIs, or post-surgical complications.

Billing Considerations

Ensure all relevant prior medical history is documented to support coding.

Infectious Disease

Documentation Requirements

Comprehensive records of infections leading to stricture, including lab results.

Common Clinical Scenarios

Patients with a history of STIs presenting with urinary symptoms.

Billing Considerations

Document the timeline of infections and subsequent urinary symptoms for accurate coding.

Coding Guidelines

Inclusion Criteria

Use N35.116 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the code is used only when the stricture is a direct result of a prior infection
  • Document all relevant clinical information to support the diagnosis

Exclusion Criteria

Do NOT use N35.116 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

52310CPT Code

Cystourethroscopy, diagnostic

Clinical Scenario

Used to evaluate the urethra in patients with suspected strictures.

Documentation Requirements

Document indications for the procedure and findings.

Specialty Considerations

Urologists should ensure all findings are clearly documented for accurate coding.

53660CPT Code

Urethral dilation

Clinical Scenario

Performed to treat urethral stricture.

Documentation Requirements

Document the extent of dilation and any complications.

Specialty Considerations

Urologists must document the reason for dilation and any prior treatments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like postinfective urethral stricture, improving data accuracy and treatment tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like postinfective urethral stricture, improving data accuracy and treatment tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like postinfective urethral stricture, improving data accuracy and treatment tracking.

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 primary cause of postinfective urethral stricture?

The primary cause is scarring and narrowing of the urethra resulting from previous infections, particularly sexually transmitted infections.

How can I differentiate between postinfective and traumatic urethral strictures?

Postinfective strictures are linked to prior infections, while traumatic strictures result from physical injury to the urethra.