N20.1 — Calculus of ureter
N20.1 is a billable, specific ICD-10-CM code for calculus of ureter. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Calculus of the ureteropelvic junction
- Ureteric stone
Risk adjustment
N20.1 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.
Medicare coverage
N20.1 is named in 6 Medicare coverage policies — 6 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A55336Billing and Coding: Retroperitoneal Ultrasound
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A57718Billing and Coding: Vitamin D Assay Testing
- A57736Billing and Coding: Vitamin D Assay Testing
How N20.1 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to N20.1.
- Calculus, calculi, calculous›ureter(impacted) (recurrent)
- Calculus, calculi, calculous›ureteropelvic junction
- Ureteritis›due to calculus
Related codes at this level
Codes that share N20. If N20.1 is not quite right, the correct code is usually one of these.
Questions about N20.1
- Is N20.1 a billable ICD-10-CM code?
- Yes. N20.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does N20.1 sit in the tabular list?
- Diseases of the genitourinary system (N00-N99), in the block Urolithiasis (N20-N23).