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v1.0.0
ICD-10 Guide
ICD-10 CodesN13.3

N13.3

Billable

Other and unspecified hydronephrosis

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

Code Description

ICD-10 N13.3 is a billable code used to indicate a diagnosis of other and unspecified hydronephrosis.

Key Diagnostic Point:

Hydronephrosis is a condition characterized by the swelling of a kidney due to a build-up of urine. This occurs when there is an obstruction in the urinary tract that prevents urine from draining properly from the kidney to the bladder. Other and unspecified hydronephrosis (ICD-10 code N13.3) encompasses cases where the specific cause of the hydronephrosis is not clearly defined or documented. It can be associated with various underlying conditions, including pyelonephritis, interstitial nephritis, and urinary tract infections (UTIs). Pyelonephritis, an infection of the kidney, can lead to hydronephrosis if the infection causes swelling and obstruction. Interstitial nephritis, which involves inflammation of the kidney's interstitial tissue, can also contribute to urinary obstruction. Drug-induced nephropathy, often resulting from medications that affect kidney function, may lead to hydronephrosis as well. Effective management often includes antibiotic therapy for infections, addressing the underlying cause of obstruction, and monitoring kidney function to prevent further complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes
  • Need for precise documentation of symptoms and history
  • Differentiation from other renal conditions
  • Potential for co-morbidities affecting coding

Audit Risk Factors

  • Inadequate documentation of the underlying cause
  • Failure to specify acute vs. chronic hydronephrosis
  • Misclassification with other renal conditions
  • Lack of supporting diagnostic tests

Specialty Focus

Medical Specialties

Nephrology

Documentation Requirements

Detailed history of renal function, imaging studies, and lab results.

Common Clinical Scenarios

Patients presenting with flank pain, hematuria, or recurrent UTIs.

Billing Considerations

Ensure clear documentation of any imaging findings and the rationale for diagnosis.

Urology

Documentation Requirements

Surgical notes, imaging results, and post-operative follow-up.

Common Clinical Scenarios

Patients with obstructive uropathy requiring surgical intervention.

Billing Considerations

Document any interventions performed to relieve obstruction.

Coding Guidelines

Inclusion Criteria

Use N13.3 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the condition's severity and any underlying causes
  • Include relevant imaging and lab results to support the diagnosis

Exclusion Criteria

Do NOT use N13.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76700CPT Code

Ultrasound, abdomen, complete

Clinical Scenario

Used to evaluate hydronephrosis in patients with flank pain.

Documentation Requirements

Document indications for ultrasound and findings.

Specialty Considerations

Nephrology and urology may require specific imaging protocols.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of hydronephrosis, improving the ability to capture the complexity of renal conditions and their management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hydronephrosis, improving the ability to capture the complexity of renal conditions and their management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of hydronephrosis, improving the ability to capture the complexity of renal conditions and their management.

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 hydronephrosis?

Common causes include kidney stones, tumors, strictures, and urinary tract infections. Each of these can lead to obstruction and subsequent hydronephrosis.

How is hydronephrosis diagnosed?

Diagnosis typically involves imaging studies such as ultrasound or CT scans, along with a thorough clinical history and physical examination.