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v1.0.0
ICD-10 Guide
ICD-10 CodesN35.811

N35.811

Billable

Other urethral stricture, male, meatal

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

Code Description

ICD-10 N35.811 is a billable code used to indicate a diagnosis of other urethral stricture, male, meatal.

Key Diagnostic Point:

N35.811 refers to a specific type of urethral stricture occurring in males, particularly at the meatus, which is the external opening of the urethra. Urethral strictures are narrowings of the urethra that can result from various causes, including trauma, infection, or inflammatory conditions. In this case, the stricture is classified as 'other,' indicating that it does not fall under more common categories of strictures. Symptoms may include difficulty urinating, a weak urine stream, or urinary retention. The condition can lead to complications such as recurrent urinary tract infections (UTIs) and bladder damage if left untreated. Diagnosis typically involves a combination of patient history, physical examination, and imaging studies such as retrograde urethrograms. Treatment options may include dilation, urethrotomy, or urethral reconstruction, depending on the severity and location of the stricture. Accurate coding is essential for proper management and reimbursement, as urethral strictures can significantly impact a patient's quality of life and require ongoing medical attention.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for precise anatomical localization
  • Differentiation from other types of urethral strictures
  • Potential for associated conditions like urethritis

Audit Risk Factors

  • Inadequate documentation of symptoms and treatment
  • Failure to specify the location of the stricture
  • Misclassification of the type of stricture
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed patient history, physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with urinary retention, recurrent UTIs, or post-surgical complications.

Billing Considerations

Urologists must document the exact location and cause of the stricture for accurate coding.

Primary Care

Documentation Requirements

Comprehensive history and physical exam, referral notes to urology if applicable.

Common Clinical Scenarios

Patients with urinary symptoms referred to urology for further evaluation.

Billing Considerations

Primary care providers should ensure they document any relevant history of trauma or infection.

Coding Guidelines

Inclusion Criteria

Use N35.811 When
  • According to ICD
  • 10 guidelines, N35
  • 811 should be used when the stricture is specifically identified as meatal and does not fall under other specified categories
  • It is important to ensure that the documentation supports the diagnosis and that the stricture is not due to a neoplasm or congenital anomaly

Exclusion Criteria

Do NOT use N35.811 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

52310CPT Code

Cystoscopy, diagnostic

Clinical Scenario

Used when evaluating a patient for urethral stricture.

Documentation Requirements

Document indications for cystoscopy and findings.

Specialty Considerations

Urologists should ensure that the procedure is justified based on clinical symptoms.

53660CPT Code

Urethral dilation

Clinical Scenario

Performed to treat a diagnosed urethral stricture.

Documentation Requirements

Document the type of stricture and the dilation technique used.

Specialty Considerations

Urologists must document the success of the procedure and any complications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of urethral strictures, improving the accuracy of data collection and reimbursement processes. N35.811 provides a clear distinction for meatal strictures, which aids in clinical management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of urethral strictures, improving the accuracy of data collection and reimbursement processes. N35.811 provides a clear distinction for meatal strictures, which aids in clinical management and research.

Reimbursement & Billing Impact

reimbursement processes. N35.811 provides a clear distinction for meatal strictures, which aids in clinical management and research.

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 urethral strictures?

Common causes include trauma, infections, inflammatory conditions, and previous surgical interventions. In males, strictures can also be associated with sexually transmitted infections.

How is a urethral stricture diagnosed?

Diagnosis typically involves a thorough patient history, physical examination, and imaging studies such as retrograde urethrograms or cystoscopy.