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v1.0.0
ICD-10 Guide
DiagnosesUreteral Calculus

Ureteral Calculus

ICD-10 Coding for Ureteral Calculus(N20.1, N13.2)

PRIMARY SPECIALTYUrology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Ureteral Calculus?
Essential facts and insights about Ureteral Calculus

Key Clinical Considerations:

  • Severe flank pain, hematuria, nausea, vomiting
  • CT scan, ultrasound, urinalysis showing crystals
  • Costovertebral angle tenderness, abdominal tenderness

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history, imaging results, symptom description
  • ICD-10-CM terminology for ureteral calculus
  • Example: 'Patient presents with flank pain and hematuria, confirmed by CT scan showing 5mm right ureteral stone.'

Coding Guidelines

Usage Guidelines & Examples

  • Follow guidelines for coding based on stone location and size.
  • Common errors include incorrect laterality or omitting associated symptoms.

Code Exclusions

Important Exclusions

  • Other types of urinary stones (e.g., bladder stones)
  • Conditions like hydronephrosis without calculus

Related ICD-10 Codes

Primary Codes
N20.0
Calculus of kidney
N20.1
Calculus of ureter
Differential Codes
N13.2
N13.2
if hydronephrosis is present due to ureteral obstruction.
N20.1
N20.1
if there is no hydronephrosis or obstruction.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Urology

Specialty Applications

  • Adults, pediatric patients with urinary issues
  • Urology clinics, emergency departments, outpatient settings

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

Documentation requirements?

Include patient symptoms, imaging results, and treatment plan.

Billing considerations?

Ensure accurate coding to reflect the complexity of the case and any procedures performed.