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ICD-10 Guide
ICD-10 CodesN15.1

N15.1

Billable

Renal and perinephric abscess

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

Code Description

ICD-10 N15.1 is a billable code used to indicate a diagnosis of renal and perinephric abscess.

Key Diagnostic Point:

A renal and perinephric abscess is a localized collection of pus within the kidney or surrounding perinephric space, often resulting from a bacterial infection. This condition can arise as a complication of pyelonephritis, where the infection spreads from the renal pelvis to the renal parenchyma, leading to inflammation and necrosis. Interstitial nephritis, characterized by inflammation of the kidney interstitium, can also contribute to abscess formation. Hydronephrosis, the swelling of a kidney due to a build-up of urine, may predispose individuals to infections and subsequent abscesses. Drug-induced nephropathy, particularly from nephrotoxic medications, can compromise renal function and increase susceptibility to infections. Urinary tract infections (UTIs) are a common precursor to renal abscesses, especially in patients with underlying anatomical abnormalities or those with a history of recurrent UTIs. Management typically involves antibiotic therapy tailored to the causative organism, and in some cases, surgical intervention may be necessary to drain the abscess. Early recognition and treatment are crucial to prevent complications such as sepsis or renal failure.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between renal abscess and other renal conditions like pyelonephritis or hydronephrosis.
  • Understanding the relationship between abscess formation and underlying conditions such as diabetes or immunosuppression.
  • Accurate documentation of the clinical scenario leading to the abscess.
  • Potential need for surgical intervention which may complicate coding.

Audit Risk Factors

  • Inadequate documentation of the abscess location and size.
  • Failure to document the underlying conditions contributing to abscess formation.
  • Misclassification of abscess type (e.g., renal vs. perinephric).
  • Lack of clarity in the treatment plan, especially regarding antibiotic therapy.

Specialty Focus

Medical Specialties

Nephrology

Documentation Requirements

Detailed clinical history, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with flank pain, fever, and signs of infection.

Billing Considerations

Documentation must clearly differentiate between abscess and other renal pathologies.

Urology

Documentation Requirements

Surgical notes, imaging studies, and post-operative care documentation.

Common Clinical Scenarios

Patients requiring drainage of renal or perinephric abscesses.

Billing Considerations

Accurate coding of surgical procedures performed in conjunction with abscess management.

Coding Guidelines

Inclusion Criteria

Use N15.1 When
  • According to ICD
  • 10 guidelines, N15
  • 1 should be used when there is a confirmed diagnosis of renal or perinephric abscess
  • Documentation must support the diagnosis, including imaging results and clinical findings

Exclusion Criteria

Do NOT use N15.1 When
  • Exclusion criteria include conditions that do not involve abscess formation

Related ICD-10 Codes

Related CPT Codes

49406CPT Code

Drainage of perinephric abscess

Clinical Scenario

Used when a perinephric abscess is identified and requires surgical intervention.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Urology specialists should ensure accurate coding of the procedure performed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of renal conditions, including renal and perinephric abscesses. This specificity aids in better tracking of disease prevalence and treatment outcomes, enhancing the quality of care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of renal conditions, including renal and perinephric abscesses. This specificity aids in better tracking of disease prevalence and treatment outcomes, enhancing the quality of care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of renal conditions, including renal and perinephric abscesses. This specificity aids in better tracking of disease prevalence and treatment outcomes, enhancing the quality of care.

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 renal and perinephric abscess?

Common causes include urinary tract infections, pyelonephritis, and complications from underlying conditions such as diabetes or immunosuppression.

How is a renal abscess diagnosed?

Diagnosis typically involves imaging studies such as ultrasound or CT scans, along with clinical evaluation of symptoms.

What is the treatment for a renal abscess?

Treatment often includes antibiotic therapy and may require surgical drainage depending on the size and severity of the abscess.