Is ICD-10-CM code N13 billable?

No, N13 (Obstructive and reflux uropathy) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code N13 belong to?

N13 belongs to Chapter 14 of the ICD-10-CM tabular list: N00–N99 (Diseases of the Genitourinary System).

N13Not billable, use a more specific code below

Obstructive and reflux uropathy

In Renal tubulo-interstitial diseases (N10-N16), chapter 14: Diseases of the Genitourinary System

18 billable codes under N13: 8 are a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.

Instructional notes

Excludes2: not included here, code separately if applicable

calculus of kidney and ureter without hydronephrosis (N20.-)
congenital obstructive defects of renal pelvis and ureter (Q62.0-Q62.3)
hydronephrosis with ureteropelvic junction obstruction (Q62.11)
obstructive pyelonephritis (N11.1)

Also applies, from Renal tubulo-interstitial diseases (N10-N16)

These notes sit on N10-N16 and apply to every code under it, including N13.

Includes: conditions that are coded here

pyelonephritis

Excludes1: not coded here, use a different code

pyeloureteritis cystica (N28.85)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Covers chronic kidney disease staging, CKD in kidney transplant patients, and sequencing CKD with related conditions such as diabetes and hypertension.

Chronic kidney disease (page 62)

Read Section I.C.14 (page 62)

All codes under N13

N13 can't be used on a claim. Pick a billable code below; grey headings group them.

N13 MS-DRGs

As the principal diagnosis, the billable codes under N13 group to these 9 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 698 Other Kidney and Urinary Tract Diagnoses with MCC (9 of 18 codes)
DRG 699 Other Kidney and Urinary Tract Diagnoses with CC (9 of 18 codes)
DRG 700 Other Kidney and Urinary Tract Diagnoses without CC/MCC (9 of 18 codes)
DRG 791 Prematurity with Major Problems (8 of 18 codes)
DRG 793 Full Term Neonate with Major Problems (8 of 18 codes)
DRG 693 Urinary Stones with MCC (7 of 18 codes)
DRG 694 Urinary Stones without MCC (7 of 18 codes)
DRG 689 Kidney and Urinary Tract Infections with MCC (2 of 18 codes)
DRG 690 Kidney and Urinary Tract Infections without MCC (2 of 18 codes)

Other codes that refer to N13

Notes on these codes point to N13.

N11.1 Excludes1: obstructive uropathy (N13.-)
N80.A4 Code Also: if applicable, obstructive and reflux uropathy (N13.-)
N80.A5 Code Also: if applicable, obstructive and reflux uropathy (N13.-)
N80.A6 Code Also: if applicable, obstructive and reflux uropathy (N13.-)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Bladder Diseases

The bladder is a hollow organ in your lower abdomen that stores urine. Many conditions can affect your bladder. Some common ones are: Doctors diagnose bladder diseases using different tests. These include urine tests, x-rays, and an examination of the bladder wall with a scope called a cystoscope. Treatment depends on the cause of the problem. It may include medicines and, in severe cases, surgery.

Kidney Diseases

You have two kidneys, each about the size of your fist. They are near the middle of your back, just below the rib cage. Inside each kidney there are about a million tiny structures called nephrons. They filter your blood. They remove wastes and extra water, which become urine. The urine flows through tubes called ureters. It goes to your bladder, which stores the urine until you go to the bathroom.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.