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 Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter.

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

Also inherited, and the opposite of Excludes1: these conditions are not part of N13.7, but a patient can have both, so you may code both.

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 N13.7

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.

N11.0Nonobstructive reflux-associated chronic pyelonephritis
N13.4Hydroureter
N11.1Chronic obstructive pyelonephritis

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 history

N13.7 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

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.

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 Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter.