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)
Excludes2 inherited from the categories above N13.7
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with N13.7
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Code history
Unchanged in every release from FY2024 to FY2027.
Code to one of these instead N13.7
4 child codes. Green means billable.
Other codes under N13
- 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