ICD-10 Coding for Ureaplasma parvum Detection in Urine
For a patient testing positive for U. parvum in urine who is prescribed antibiotics, the appropriate ICD-10 code depends critically on whether the patient has symptoms of urethritis or urinary tract infection—you should NOT code for infection if the patient is asymptomatic, as U. parvum is commonly a commensal organism.
Clinical Context Determines Coding
If Patient Has Symptoms of Urethritis or UTI:
Use N34.1 (Nonspecific urethritis) for symptomatic urethritis with documented U. parvum, as the European Association of Urology notes that the pathogenic role of Ureaplasma species is debated, with recent data suggesting U. urealyticum (but not U. parvum) is an etiological agent in non-gonococcal urethritis 1. However, if antibiotics were prescribed, the clinician likely deemed it clinically significant.
Alternative codes for symptomatic presentations:
- N39.0 (Urinary tract infection, site not specified) if presenting with general UTI symptoms 1
- N34.2 (Other urethritis) for documented urethral inflammation 1
If Patient is Asymptomatic:
Do NOT use an infection code. The European Association of Urology strongly recommends against treating asymptomatic bacteriuria in general populations 1. If antibiotics were prescribed despite asymptomatic status, this represents questionable clinical practice 2, 3.
If coding is required for the laboratory finding alone:
- R82.79 (Other abnormal findings on microbiological examination of urine) for the positive test result without clinical infection 1
Critical Coding Pitfalls to Avoid
Do not automatically code U. parvum detection as an infection, as asymptomatic carriage is common in 40-80% of detected cases 3. The European Association of Urology recommends only treating U. urealyticum when there are symptoms of urethritis or documented urethritis (≥5 PMNs/HPF on urethral smear) 2.
U. parvum specifically has questionable pathogenicity compared to U. urealyticum. Recent evidence suggests U. urealyticum, but not U. parvum, is an etiological agent in non-gonococcal urethritis 1, 2.
Avoid coding for "Mycoplasma infection" generically, as this may not accurately reflect the clinical scenario and U. parvum is not classified as a traditional sexually transmitted infection requiring routine treatment 3.
Documentation Requirements for Proper Coding
To justify an infection code, documentation should include 1, 2:
- Presence of urethral discharge, dysuria, or urethral pruritus
- Objective findings of urethritis (≥5 PMNs per high-power field on urethral smear)
- Exclusion of other traditional STI agents (N. gonorrhoeae, C. trachomatis, M. genitalium, T. vaginalis) 3
- Quantitative testing showing high bacterial load if available 4
If the patient is undergoing a traumatic urinary tract procedure, asymptomatic bacteriuria treatment may be justified, and coding would reflect both the procedure and the pre-procedural infection management 2.