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ICD-10 Guide
ICD-10 CodesN35.012

N35.012

Billable

Post-traumatic membranous urethral stricture

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

Code Description

ICD-10 N35.012 is a billable code used to indicate a diagnosis of post-traumatic membranous urethral stricture.

Key Diagnostic Point:

Post-traumatic membranous urethral stricture refers to a narrowing of the membranous urethra that occurs as a result of trauma, which can be due to blunt or penetrating injuries, surgical procedures, or other forms of trauma to the pelvic region. This condition can lead to significant urinary symptoms, including difficulty urinating, urinary retention, and recurrent urinary tract infections. The membranous urethra is the shortest and most vulnerable segment of the urethra, making it particularly susceptible to injury. Diagnosis typically involves a combination of patient history, physical examination, and imaging studies such as retrograde urethrograms or cystoscopy. Treatment options may include urethral dilation, urethrotomy, or surgical reconstruction, depending on the severity and length of the stricture. Proper management is crucial to restore normal urinary function and prevent complications such as bladder damage or chronic urinary issues.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of anatomical terminology related to the urinary system.
  • Differentiation from other types of urethral strictures.
  • Need for precise documentation of trauma history.
  • Potential for multiple treatment options affecting coding.

Audit Risk Factors

  • Inadequate documentation of the traumatic event.
  • Failure to specify the location and type of stricture.
  • Misclassification of the stricture type.
  • Lack of supporting imaging or procedural documentation.

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed history of trauma, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with urinary retention post-trauma, recurrent UTIs, or complications from previous surgeries.

Billing Considerations

Ensure clarity in the documentation of the stricture's cause and any prior interventions.

Emergency Medicine

Documentation Requirements

Immediate assessment of trauma, including mechanism of injury and initial management steps.

Common Clinical Scenarios

Patients with pelvic fractures or blunt abdominal trauma presenting with urinary symptoms.

Billing Considerations

Accurate coding of the initial trauma and subsequent referrals to urology.

Coding Guidelines

Inclusion Criteria

Use N35.012 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the code is used only when the stricture is specifically due to trauma

Exclusion Criteria

Do NOT use N35.012 When
  • Exclude cases of congenital or idiopathic strictures

Related ICD-10 Codes

Related CPT Codes

52332CPT Code

Cystourethroscopy with dilation

Clinical Scenario

Used when performing dilation of a urethral stricture.

Documentation Requirements

Document the findings during cystoscopy and the need for dilation.

Specialty Considerations

Urology specialists should ensure accurate reporting of the procedure performed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 allows for more specific coding of conditions like post-traumatic membranous urethral stricture, improving data accuracy and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 allows for more specific coding of conditions like post-traumatic membranous urethral stricture, improving data accuracy and facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 allows for more specific coding of conditions like post-traumatic membranous urethral stricture, improving data accuracy and facilitating better patient 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 is the primary cause of post-traumatic membranous urethral stricture?

The primary cause is trauma to the pelvic region, which can occur from accidents, surgical procedures, or penetrating injuries.