Urology Coding Alert

Check the urologist's documentation for mention of infection to start down the right code path.When your urologist documents that a patient has hydronephrosis, you report 591 (Hydronephrosis) -- which may include any or all of the following clinical scenarios: early hydronephrosis, hydronephrosis with an atrophic kidney, a functionless and infected kidney, intermittent hydronephrosis, or a primary or secondary type of hydronephrosis. When ICD-9 becomes ICD-10 in 2013, you'll still have one diagnosis code for atrophic, early, functionless, intermittent, primary, and secondary not elsewhere classified (NEC) hydronephrosis: N13.30 (Unspecified hydronephrosis). For other specified types of hydronephrosis NEC, you'll use N13.39 (Other hydronephrosis).ICD-10 difference: When your urologist states the patient has hydronephrosis with an infection, an obstruction, or a ureteral stricture you'll need to learn new codes. With ICD-10, you'll report one of the following:With infection (including obstruction or stricture with infection) -- N13.6, PyonephrosisWith obstruction by renal or ureteral calculus -- [...]