Urology Coding Alert

Plus: Pay attention to your extra diagnosis choice.

When selecting an ICD-10 diagnostic code for retention of urine, you still have several codes to choose from, just as you did for all those years with ICD-9. But providers and coders will both have to pay attention to some documentation details to ensure the correct code gets reported.

In the past: Your three diagnostic choices for urinary retention in ICD-9 were:

• 788.20 – Retention of urine, unspecified
• 788.21 – Incomplete bladder emptying
• 788.29 – Other specified retention of urine.

ICD-10 expands your options and offers other guidance to files claims correctly. Here’s how the old diagnoses are reflected in ICD-10.

Pay attention to any notes or guidelines associated with a particular diagnosis.

Example 1: A note with R33.8 instructs you to “Code first, if applicable, any causal conditions, such as enlarged prostate (N40.1).

Example 2: Diagnosis R33.0 states that you should “Use additional code for adverse effect, if applicable, to identify drug (T36-T50) with the fifth or sixth character.”