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v1.0.0
ICD-10 Guide
ICD-10 CodesN35.813

N35.813

Billable

Other membranous urethral stricture, male

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

Code Description

ICD-10 N35.813 is a billable code used to indicate a diagnosis of other membranous urethral stricture, male.

Key Diagnostic Point:

N35.813 refers to a specific type of urethral stricture affecting the membranous portion of the urethra in males. Urethral strictures are narrowings of the urethra that can result from various causes, including trauma, infection, or inflammatory conditions. In this case, the term 'other' indicates that the stricture does not fall into the more common categories of strictures, such as those caused by congenital anomalies or post-surgical complications. Symptoms may include difficulty urinating, a weak urine stream, or urinary retention. 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 urethroplasty, depending on the severity and location of the stricture. Accurate coding is essential for proper reimbursement and to ensure that the patient's medical history is correctly documented.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in the presentation of urethral strictures
  • Differentiation from other urinary disorders
  • Need for precise documentation of the stricture's location and cause
  • Potential for co-existing conditions affecting the urinary system

Audit Risk Factors

  • Inadequate documentation of the stricture's characteristics
  • Failure to specify the cause of the stricture
  • Misclassification of the type of stricture
  • Inconsistent coding practices among providers

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed patient history, imaging studies, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with urinary retention, recurrent urinary tract infections, or post-traumatic urethral injuries.

Billing Considerations

Urologists must ensure that the cause of the stricture is clearly documented to support the use of N35.813.

Radiology

Documentation Requirements

Imaging reports must clearly indicate the presence and characteristics of the stricture.

Common Clinical Scenarios

Performing retrograde urethrograms or other imaging studies to assess urethral strictures.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use N35.813 When
  • According to ICD
  • 10 coding guidelines, N35
  • 813 should be used when the stricture is specifically identified as membranous and not due to other specified conditions
  • It is important to document the cause and any associated symptoms

Exclusion Criteria

Do NOT use N35.813 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

52310CPT Code

Cystoscopy, with urethral dilation

Clinical Scenario

Used when performing dilation of a membranous urethral stricture.

Documentation Requirements

Document the findings during cystoscopy and the need for dilation.

Specialty Considerations

Urologists should ensure that the procedure is clearly linked to the diagnosis of N35.813.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding urethral strictures, improving the accuracy of patient records and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding urethral strictures, improving the accuracy of patient records and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 causes of membranous urethral stricture?

Common causes include trauma, surgical complications, infections, and inflammatory conditions. Accurate documentation of the cause is essential for coding.