The exact ICD-10-CM diagnosis code for nephrolithiasis, commonly known as kidney stones, is N20.0. This code specifically refers to "Calculus of kidney."
Understanding Nephrolithiasis and its ICD-10 Code
Nephrolithiasis is a medical condition characterized by the formation of solid masses, or stones, within the kidneys. These stones are typically composed of minerals and salts. When documenting and billing for medical services related to this condition, healthcare providers utilize the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes to ensure accuracy and consistency.
The ICD-10-CM system is a comprehensive set of codes used to classify diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases. For nephrolithiasis, the most precise code to use is N20.0.
The Specific Code: N20.0
| Condition | ICD-10-CM Code | Description |
|---|---|---|
| Nephrolithiasis | N20.0 | Calculus of kidney |
This code, N20.0, is specifically designated for the presence of calculi (stones) within the kidney itself. It is crucial for accurate medical record-keeping, billing, and health statistics. As per the 2025 ICD-10-CM guidelines, N20.0 is the appropriate diagnosis code for this condition. For more detailed information, you can refer to the official coding guidelines for ICD-10-CM Diagnosis Code N20.0.
Why Accurate Coding Matters
Accurate ICD-10 coding is fundamental in healthcare for several reasons:
- Reimbursement: Insurance companies and government payers rely on these codes to process claims and provide appropriate reimbursement for services rendered. Incorrect coding can lead to denied claims or delayed payments.
- Epidemiology and Public Health: Coded data helps track the incidence and prevalence of diseases, aiding public health surveillance and research.
- Resource Allocation: Understanding disease patterns through coded data assists healthcare systems in allocating resources effectively, such as planning for specific medical equipment or specialist availability.
- Patient Care and Research: Precise coding contributes to comprehensive patient records, supporting continuity of care and enabling valuable clinical research.
Related Considerations for Nephrolithiasis Coding
While N20.0 covers the general presence of kidney stones, specific clinical scenarios might require additional or more detailed coding:
- Laterality: If the stone is specified as affecting the left or right kidney, sub-codes might be used if available (e.g., N20.01 for calculus of right kidney, N20.02 for calculus of left kidney, N20.00 for unspecified kidney – though N20.0 defaults to unspecified if no further digit). Always check the most current and specific coding guidance.
- Associated Conditions: If nephrolithiasis leads to other complications, such as hydronephrosis (swelling of the kidney due to urine backup), these conditions would be coded separately in addition to N20.0.
- Location Beyond Kidney: If the stone has moved to other parts of the urinary tract, such as the ureter (ureterolithiasis) or bladder (cystolithiasis), different codes (e.g., N20.1 for calculus of ureter, N21.0 for calculus in bladder) would be used.
In summary, for uncomplicated nephrolithiasis, the N20.0 code serves as the primary and most accurate ICD-10-CM designation.
