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v1.0.0
ICD-10 Guide
ICD-10 CodesN35.916

N35.916

Billable

Unspecified urethral stricture, male, overlapping sites

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

Code Description

ICD-10 N35.916 is a billable code used to indicate a diagnosis of unspecified urethral stricture, male, overlapping sites.

Key Diagnostic Point:

N35.916 refers to an unspecified urethral stricture in males, where the stricture occurs at overlapping sites within the urethra. Urethral strictures are narrowings of the urethra that can result from various causes, including trauma, infection, or inflammation. In males, these strictures can lead to significant urinary symptoms such as difficulty urinating, urinary retention, and recurrent urinary tract infections (UTIs). The condition may arise from chronic urethritis, which is inflammation of the urethra often caused by sexually transmitted infections or other irritants. The overlapping sites designation indicates that the stricture may not be localized to a single area, complicating diagnosis and treatment. Management often involves urethral dilation, urethrotomy, or surgical reconstruction, depending on the severity and location of the stricture. Accurate coding is essential for appropriate treatment planning and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for precise documentation of stricture location
  • Differentiation from other urethral disorders
  • Potential for overlapping diagnoses

Audit Risk Factors

  • Inadequate documentation of stricture characteristics
  • Failure to specify overlapping sites
  • Misclassification of urethral disorders
  • Inconsistent coding practices across providers

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed notes on stricture location, symptoms, and treatment history.

Common Clinical Scenarios

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

Billing Considerations

Ensure documentation reflects the complexity of overlapping sites and any prior treatments.

Primary Care

Documentation Requirements

Comprehensive history and physical examination notes, including urinary symptoms.

Common Clinical Scenarios

Initial evaluation of patients with urinary symptoms or suspected urethral stricture.

Billing Considerations

Referral to urology should be documented if stricture is suspected.

Coding Guidelines

Inclusion Criteria

Use N35.916 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the documentation supports the diagnosis of urethral stricture
  • Include details about overlapping sites and any associated conditions

Exclusion Criteria

Do NOT use N35.916 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

52310CPT Code

Cystoscopy, diagnostic

Clinical Scenario

Used to evaluate the urethra in patients with suspected stricture.

Documentation Requirements

Document indications for cystoscopy and findings.

Specialty Considerations

Urology specialists should ensure thorough documentation of findings.

53660CPT Code

Urethral dilation

Clinical Scenario

Performed to treat urethral stricture.

Documentation Requirements

Document the procedure details and patient response.

Specialty Considerations

Urologists must document the extent of dilation and any complications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of urethral strictures, improving the granularity of data for treatment and outcomes. N35.916 captures the complexity of overlapping sites, which was less defined in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of urethral strictures, improving the granularity of data for treatment and outcomes. N35.916 captures the complexity of overlapping sites, which was less defined in ICD-9.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of urethral strictures, improving the granularity of data for treatment and outcomes. N35.916 captures the complexity of overlapping sites, which was less defined in ICD-9.

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 overlapping sites in urethral stricture?

Overlapping sites indicate that the stricture may not be confined to a single area, complicating treatment and requiring careful documentation to ensure appropriate management.