ED Coding and Reimbursement Alert

Question: A patient presented to our ED with groin pain and the ED physician diagnosed him with a calcified ureteral stent. We called upon a urologist to handle the removal, but which diagnosis would we assign with our E/M code for the visit?

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Answer: To ensure correct payment for your E/M service, report diagnostic code N20.0 (Calculus of kidney) for stone fragmentation of the stent in the renal pelvis or N20.1 (Calculus of ureter) for stone fragmentation of the stent in the ureter. The current edition of ICD-10-CM does not include a specific diagnosis for “calcified ureteral stent.” Because the calcification could be considered a complication of genitourinary devices, an appropriate secondary diagnosis code could be T83.192A (Other mechanical complication of indwelling ureteral stent, initial encounter).