What are the ICD-10 (International Classification of Diseases, 10th Revision) codes for urinary obstruction and gross hematuria?

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ICD-10 Codes for Urinary Obstruction and Gross Hematuria

The ICD-10 code for urinary obstruction is N13.9 (obstructive uropathy, unspecified) or more specific codes depending on the etiology, while gross hematuria is coded as R31.0 (gross hematuria).

Primary ICD-10 Codes

Gross Hematuria

  • R31.0 - Gross hematuria (macroscopic hematuria, visible blood in urine) 1, 2
  • This code applies when blood is visibly present in the urine without microscopic examination 1

Urinary Obstruction

  • N13.9 - Obstructive and reflux uropathy, unspecified 3
  • N13.8 - Other obstructive and reflux uropathy 3
  • N13.0 - Hydronephrosis with ureteropelvic junction obstruction 3
  • N13.1 - Hydronephrosis with ureteral stricture, not elsewhere classified 3
  • N13.30 - Unspecified hydronephrosis 3

Additional Relevant Codes Based on Etiology

If Obstruction is Due to Blood Clot

  • N13.8 - Other obstructive uropathy (can be used for clot obstruction) 4
  • R31.0 - Gross hematuria (as the underlying cause) 4, 5

If Urinary Retention is Present

  • R33.9 - Retention of urine, unspecified 6
  • R33.8 - Other retention of urine 6

Clinical Context for Code Selection

When Obstruction is Documented

  • Use specific N13 codes when imaging or clinical findings confirm structural or functional urinary tract blockage 3
  • Obstructive uropathy accounts for 5-10% of acute kidney injury cases and requires prompt identification 3

When Hematuria is the Primary Presentation

  • R31.0 should be used for gross hematuria regardless of whether obstruction is present 1, 2
  • Gross hematuria carries 30-40% association with malignancy and requires urgent evaluation 1, 2, 7

Important Coding Considerations

Multiple Diagnoses

  • Both codes can be used together when a patient presents with both urinary obstruction and gross hematuria, as these conditions frequently coexist 4, 5
  • Code the primary reason for the encounter first, followed by secondary diagnoses 3

Specificity Matters

  • Always use the most specific code available based on the documented etiology and location of obstruction 3
  • If the cause of obstruction is known (stone, tumor, stricture), use the appropriate specific code rather than unspecified 3

References

Guideline

Hematuria Evaluation and Management

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Evaluation of Hematuria in the Elderly

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Diagnostic Approaches for Endometriosis-Related Urinary Tract Symptoms

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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