N13.7
N13.7 — Vesicoureteral-reflux
Non-billable headerICD-10-CM
N13.7 is a non-billable header ICD-10-CM code for vesicoureteral-reflux. It cannot be billed on its own: choose one of the more specific child codes below.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- reflux-associated pyelonephritis (N11.0)
Other codes that can never be billed with N13.7
These codes carry an Excludes1 note pointing at N13.7. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading N13.7 alone.
Risk adjustment
N13.7 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead N13.7
4 child codes. Green means billable.
Related codes at this level
Codes that share N13. If N13.7 is not quite right, the correct code is usually one of these.
- N13.0Hydronephrosis with ureteropelvic junction obstruction
- 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
- N13.6Pyonephrosis
- N13.8Other obstructive and reflux uropathy
- N13.9Obstructive and reflux uropathy, unspecified
Questions about N13.7
- Is N13.7 a billable ICD-10-CM code?
- No. N13.7 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does N13.7 sit in the tabular list?
- Diseases of the genitourinary system (N00-N99), in the block Renal tubulo-interstitial diseases (N10-N16).
- What cannot be coded together with N13.7?
- N13.7 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.