Find information on ureterolithiasis diagnosis, including clinical documentation requirements, medical coding guidelines, and ICD-10 codes for ureteral stones. Learn about symptoms, treatment options, and best practices for healthcare professionals documenting and coding ureterolithiasis in medical records. This resource provides comprehensive information on ureteric calculi, kidney stones causing ureteral obstruction, and renal colic related to ureterolithiasis for accurate clinical documentation and medical coding.
Also known as
Calculus of ureter
Stones present in the ureter.
Calculus of kidney and ureter
Stones present in both kidney and ureter.
Retention of urine, unspecified
Inability to completely empty the bladder, sometimes caused by a stone.
Colic, renal and ureteric
Pain caused by kidney or ureteral stones.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the ureteral calculus specified as right or left?
Yes
Right ureter?
No
Is it bilateral?
When to use each related code
| Description |
|---|
| Kidney stone in the ureter |
| Kidney stone (Nephrolithiasis) |
| Bladder stone (Cystolithiasis) |
Missing or unclear documentation of stone location (right, left, bilateral) impacts code selection (N20.0, N20.1, N20.2). CDI query needed.
Failure to code associated obstruction (N13.x) when present leads to underreporting severity and potential lost reimbursement. Review MD notes.
Lack of stone size documentation prevents accurate coding and potential medical necessity validation for certain procedures. Query physician.
Q: What are the most effective evidence-based strategies for managing acute ureterolithiasis pain in the emergency department setting?
A: Managing acute ureterolithiasis pain effectively requires a multimodal approach. Current evidence supports the use of NSAIDs like ketorolac as first-line therapy, often in combination with opioids if needed for severe pain. Consider implementing adjunctive therapies such as intravenous fluids and antiemetics to improve patient comfort and hydration status. For patients with contraindications to NSAIDs, consider paracetamol or other analgesics. Explore how shared decision-making can be employed to tailor pain management strategies to individual patient needs and preferences in the ED. Remember to reassess pain regularly and adjust treatment accordingly.
Q: How can I differentiate ureterolithiasis from other causes of acute flank pain in a pregnant patient, considering the limitations of imaging modalities?
A: Differentiating ureterolithiasis from other causes of flank pain during pregnancy can be challenging. While ultrasound is often the preferred initial imaging modality due to its safety profile, its sensitivity for detecting small ureteral stones can be limited. Clinical features such as radiating pain to the groin, hematuria (even microscopic), and nausea/vomiting suggest ureterolithiasis. Consider urine analysis and cultures to rule out infection. If ultrasound is inconclusive but suspicion remains high, low-dose CT with shielding may be warranted after careful risk-benefit discussion with the patient and radiologist. Learn more about the AUA/SUFU Guideline on the management of ureterolithiasis for further guidance on imaging during pregnancy.
Patient presents with complaints consistent with ureterolithiasis, including acute flank pain radiating to the groin, hematuria, and nausea. Onset of symptoms began [Number] dayshours ago after [Onset descriptor, e.g., strenuous exercise, large meal]. Pain is described as [Pain descriptor, e.g., sharp, colicky, constant] and rated [Pain scale rating] on a 0-10 scale. Review of systems reveals [Positive findings]. Patient denies [Pertinent negatives, e.g., fever, chills, dysuria]. Past medical history includes [Relevant medical history, e.g., hypertension, diabetes, previous kidney stones]. Surgical history includes [Relevant surgical history]. Family history is significant for [Relevant family history, e.g., kidney stones]. Medications include [Current medications]. Allergies include [Allergies]. Physical examination reveals [Objective findings, e.g., costovertebral angle tenderness, no palpable masses]. A urinalysis was ordered and showed [Urinalysis results, e.g., microscopic hematuria, presence of crystals]. Kidney stone symptoms are suggestive of ureteral obstruction. Differential diagnosis includes nephrolithiasis, pyelonephritis, appendicitis, and other causes of abdominal pain. A CT scan of the abdomen and pelvis without contrast was ordered to confirm the diagnosis and assess stone size and location. Preliminary diagnosis of ureterolithiasis is suspected. Plan includes pain management with [Analgesic name and dosage], hydration with IV fluids, and antiemetics as needed. Patient education provided on dietary modifications to prevent future stone formation, including increased fluid intake and limiting oxalate-rich foods. Follow-up scheduled with urology for definitive management and discussion of treatment options such as medical expulsive therapy, extracorporeal shock wave lithotripsy (ESWL), or ureteroscopy. Patient advised to return to the emergency department if symptoms worsen or new symptoms develop.