N11.1
N11.1: Chronic obstructive pyelonephritis
Billable / specific codeICD-10-CM
N11.1 is a billable, specific ICD-10-CM code for chronic obstructive pyelonephritis. It is valid for submission on a claim.
Check N11.1 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Pyelonephritis (chronic) associated with anomaly of pelviureteric junction
- Pyelonephritis (chronic) associated with anomaly of pyeloureteric junction
- Pyelonephritis (chronic) associated with crossing of vessel
- Pyelonephritis (chronic) associated with kinking of ureter
- Pyelonephritis (chronic) associated with obstruction of ureter
- Pyelonephritis (chronic) associated with stricture of pelviureteric junction
- Pyelonephritis (chronic) associated with stricture of ureter
Other codes that can never be billed with N11.1
Their own Excludes1 notes name this code, so the conflict is not listed above.
- N03Chronic nephritic syndrome
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
N11.1 is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A55336Billing and Coding: Retroperitoneal Ultrasound
- A56421Billing and Coding: CT of the Abdomen and Pelvis
Alphabetic index entries that lead here
- Pyelonephrosis(obstructive)
- Obstruction, obstructed, obstructive›pyelonephritis(chronic)
- Pyelonephritis›chronic›associated with ureteral obstruction or stricture
- Pyelonephritis›chronic›obstructive
- Pyelonephritis›in›obstruction
- Kink, kinking›ureter›with›pyelonephritis(chronic)
- Nephritis, nephritic›tubulo-interstitial›chronic›obstructive
- Obstruction, obstructed, obstructive›ureter NEC›with›pyelonephritis(chronic)
- Stricture›ureter›with›pyelonephritis(chronic)
Code history
Unchanged in every release from FY2024 to FY2027.