N13.6

N13.6: Pyonephrosis

Billable / specific codeICD-10-CM

N13.6 is a billable, specific ICD-10-CM code for pyonephrosis. It is valid for submission on a claim.

Check N13.6 with the rest of the claim: free scrubber

Use additional code

Add a secondary code to capture the detail described below.

code (B95-B97), to identify infectious agent.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Conditions in N13.0-N13.5 with infection
Obstructive uropathy with infection

Excludes2 inherited from the categories above N13.6

Not part of this code, but both may be coded when both are present.

Written on N13: Obstructive and reflux uropathy

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)

Other codes that can never be billed with N13.6

Their own Excludes1 notes name this code, so the conflict is not listed above.

M72.8Other fibroblastic disorders
N11.1Chronic obstructive pyelonephritis
N13.1Hydronephrosis with ureteral stricture, not elsewhere classified
N13.2Hydronephrosis with renal and ureteral calculous obstruction
N13.3Other and unspecified hydronephrosis
N13.4Hydroureter
N13.5Crossing vessel and stricture of ureter without hydronephrosis
N39.0Urinary tract infection, site not specified

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

N13.6 is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A55336Billing and Coding: Retroperitoneal Ultrasound

Alphabetic index entries that lead here

Hydropyonephrosis
Pyohydronephrosis
Pyonephrosis
Hydroureter›with infection
Ormond's disease›with infection
Angulation›ureter›with infection
Calculus, calculi, calculous›pyelitis›with hydronephrosis
Calculus, calculi, calculous›pyelonephritis›with hydronephrosis
Constriction›ureter›with infection
Contraction, contracture, contracted›ureterovesical orifice›with infection
Fasciitis›perirenal›with infection
Fibrosis, fibrotic›retroperitoneal›with infection

Code history

Unchanged in every release from FY2024 to FY2027.