Urology Coding Alert

The related diagnoses might point you to additional options.

Neurogenic bladder is a condition that results from nerve damage causing impaired bladder function.

Several nerves converge at the bladder to control the urinary tract muscles. These include the sphincter muscles that normally form a tight ring around the urethra and keep urine contained until it’s voluntarily released. Damage to those controlling nerves can be caused by a variety of things and can lead to problems such as urinary incontinence or neurogenic bladder.

When you began reporting diagnoses based on ICD-10, the old catch-all code of 596.54 (Neurogenic bladder NOS) was expanded into five related diagnoses:

• N31.9 – Neuromuscular dysfunction of bladder, unspecified
• N31.0 – Uninhibited neuropathic bladder, not otherwise classified
• N31.1 – Reflex neuropathic bladder, not elsewhere classified
• N31.2 – Flaccid neuropathic bladder, not elsewhere classified
• N31.8 – Other neuromuscular dysfunction of bladder.

Note that if you report N31.8, you’re directed to also include an additional code to identify an associated urinary incontinence. These diagnoses fall under codes N39.3 (Stress incontinence [female] [male]) and N39.4 (Other specified urinary incontinence).

If you’re pointed to an additional code from N39.4, you’ll need to dig a bit deeper to take the code to a fifth digit:

• N39.41 – Urge incontinence
• N39.42 – Incontinence without sensory awareness
• N39.43 – Post-void dribbling
• N39.44 – Nocturnal enuresis
• N39.45 – Continuous leakage
• N39.46 – Mixed incontinence.

If the diagnosis you’re seeking doesn’t quite fit any of those N39.4~ choices, you’ll look to N39.49 (Other specified urinary incontinence). This code family expands to six digits:

• N39.490 – Overflow incontinence
• N39.491 – Coital incontinence
• N39.492 – Postural (urinary) incontinence 
• N39.498 – Other specified urinary incontinence (such as reflex incontinence or total incontinence).