Urology Coding Alert

The unspecified code is probably not going to be good enough in the near future.

When your urologist treats a patient for a urinary tract infection, you may lean on the unspecified ICD-9 code: 599.0 (Urinary tract infection site not specified). Picking a non-specific code isn’t your best bet in ICD-9, and when ICD-10 rolls around on Oct. 1, 2015 specificity will be even more crucial.

Start here: ICD-9 code 599.0 does crosswalk to ICD-10 code N39.0 (Urinary tract infection, site not specified). The challenge is that ICD-10 offers you several much more specific infection codes that you should assign instead of N39.0, based on the details of your urologist’s documentation.

N39.0 “is okay,” said Jonathan Rubenstein, MD, director of coding and physician compliance for Chesapeake Urology Associates in Baltimore, in his CodingCon 2014 session “ICD-10 in Urology” in Orlando, Fla. “My concern is that insurers are more likely to scrutinize unspecified codes. Lack of specificity increases the risk of denials and requests for clarification or further information.”

Note: There will be times that you will legitimately use N39.0, Rubenstein says. But you should be cautious and be as specific as your urologist’s documentation allows.

Bottom line: Get your urologist to document the specific information he knows about the patient’s urinary tract infection, and then choose the most specific code you can. Use this chart from Dr. Rubenstein to get to know your options.