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v1.0.0
ICD-10 Guide
ICD-10 CodesN21.0

N21.0

Billable

Calculus in bladder

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

Code Description

ICD-10 N21.0 is a billable code used to indicate a diagnosis of calculus in bladder.

Key Diagnostic Point:

Calculus in the bladder, commonly referred to as bladder stones, occurs when minerals and salts crystallize and form solid masses within the bladder. This condition can arise from various factors, including urinary stasis, dehydration, and certain dietary habits. Patients may experience symptoms such as hematuria (blood in urine), dysuria (painful urination), and frequent urination. The presence of bladder stones can lead to complications such as urinary tract infections and obstruction of urine flow. Diagnosis typically involves imaging studies, such as ultrasound or CT scans, and urinalysis to identify the presence of stones and assess kidney function. Treatment options vary based on the size and composition of the stones, with smaller stones often managed through increased fluid intake and dietary modifications, while larger stones may require procedures like lithotripsy or surgical removal. Understanding the underlying causes and appropriate management strategies is crucial for preventing recurrence and ensuring patient well-being.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of treatment options (medical vs. surgical)
  • Need for precise documentation of symptoms and imaging results
  • Differentiation from other urolithiasis codes
  • Potential for co-morbid conditions affecting treatment

Audit Risk Factors

  • Inadequate documentation of symptoms
  • Failure to document imaging studies
  • Misclassification of stone location
  • Lack of clarity on treatment plan

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed notes on patient history, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with hematuria, recurrent urinary tract infections, or obstructive symptoms.

Billing Considerations

Ensure accurate coding of stone size and location, as well as any surgical interventions performed.

Nutrition

Documentation Requirements

Assessment of dietary habits and recommendations for dietary modifications.

Common Clinical Scenarios

Patients with recurrent bladder stones needing dietary intervention.

Billing Considerations

Document specific dietary changes recommended to prevent recurrence of stones.

Coding Guidelines

Inclusion Criteria

Use N21.0 When
  • According to the official coding guidelines, N21
  • 0 should be used when the documentation specifies the presence of calculus in the bladder
  • Coders must ensure that the diagnosis is supported by imaging studies and that any related conditions are also documented

Exclusion Criteria

Do NOT use N21.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

52332CPT Code

Cystolitholapaxy

Clinical Scenario

Used for the removal of bladder stones during cystoscopy.

Documentation Requirements

Document the size and number of stones removed.

Specialty Considerations

Urologists must ensure that the procedure is medically necessary and well-documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of bladder stones, improving the accuracy of data collection and reimbursement processes. N21.0 provides a clear distinction from other types of urolithiasis, enhancing clinical understanding and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of bladder stones, improving the accuracy of data collection and reimbursement processes. N21.0 provides a clear distinction from other types of urolithiasis, enhancing clinical understanding and treatment planning.

Reimbursement & Billing Impact

reimbursement processes. N21.0 provides a clear distinction from other types of urolithiasis, enhancing clinical understanding and treatment planning.

Resources

Clinical References

  • •
    American Urological Association Guidelines

Coding & Billing References

  • •
    American Urological Association Guidelines

Frequently Asked Questions

What are the common symptoms of bladder stones?

Common symptoms include hematuria, dysuria, frequent urination, and suprapubic pain.

How are bladder stones diagnosed?

Diagnosis typically involves imaging studies such as ultrasound or CT scans, along with urinalysis.

What treatment options are available for bladder stones?

Treatment may include increased fluid intake, dietary modifications, lithotripsy, or surgical removal depending on the size and type of stones.