Urology Coding Alert

Keep this list handy to distinguish between the types.

Urinary incontinence (the involuntary leakage of urine) might be a familiar diagnosis in your practice, but that doesn’t mean all the cases are the same. There are many different potential causes of urinary incontinence, and a patient may experience more than one type at a time, according to Maureen Valvo, BSN, RN, RAC-CT, senior quality improvement specialist with the Quality Improvement Organization (QIO) IPRO, part of the Atlantic Quality Innovation Network.

Some of the most common types of urinary incontinence include:

• Stress incontinence — occurs with coughing, sneezing, laughing, lifting, standing from a sitting position, climbing stairs, etc.
• Urge incontinence — occurs due to an overactive or spastic bladder and involves a sudden, strong urge to expel moderate to large amounts of urine before the bladder is full.
• Mixed incontinence — is a combination of stress and urge incontinence.
• Overflow incontinence — is due to a blocked urethra or weak bladder muscles, causing leakage of small amounts of urine when the bladder has reached its maximum capacity and has become distended.
• Transient temporary/occasional incontinence — is related to a potentially improvable or reversible cause.
• Functional incontinence — occurs when one cannot get to the toilet in time due to physical disability, external obstacles, problems thinking or communi­cating, or availability of staff assistance.

Now take a look at the codes you should rely on to report urinary incontinence under ICD-10:

• N39.3 — Stress incontinence (female) (male)
• 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
• N39.490 — Overflow incontinence
• N39.498 — Other specified urinary incontinence
• R32 — Unspecified urinary incontinence.

Remember that since the inception of the ICD-10 diagnostic code set, you should rarely need to submit unspecified diagnostic codes (such as R32) unless there are no other applicable codes to be used.