ICD-10-CM Billable Code

N13.7

Vesicoureteral-reflux

Clinical Classification Guidelines

Excludes Type 1

  • reflux-associated pyelonephritis (N11.0)

Medical Intelligence & Overview

Vesicoureteral reflux (VUR) is a condition where urine flows backward from the bladder into the ureters and sometimes to the kidneys. This abnormal flow can lead to urinary tract infections and potential kidney damage if left untreated. VUR is commonly diagnosed in infants and children but can occasionally be found in adults. Recognizing the signs and understanding the causes, symptoms, and treatment options are essential for managing this condition effectively and preventing complications.

Causes & Symptoms

Clinical Causes: Congenital weakness in the vesicoureteral junction where the ureter connects to the bladder, allowing urine to reflux. Increased bladder pressure due to infections or structural abnormalities. Genetic factors that affect the development of the urinary tract. Obstructions or abnormalities in the urinary tract that alter normal urine flow. Secondary causes such as bladder or urethral dysfunction.

Key Symptoms: Recurrent urinary tract infections, especially in children. Fever, chills, and irritability caused by infections. Pain or burning sensation during urination. Frequent or urgent urination. In some cases, no noticeable symptoms are present, especially in mild cases.

Diagnostic & Treatment

Diagnosis Path: Diagnosis of vesicoureteral reflux typically involves a combination of medical history review and diagnostic tests. These may include:

Treatment Protocols: Treatment options aim to prevent infections and protect kidney health. They depend on the severity of reflux and may include:

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

Clinical Advice & FAQs

Billing Guidance

Is N13.7 a billable ICD-10 code?
Yes, N13.7 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report N13.7?
Clinical documentation must specify the nature of Vesicoureteral-reflux and any associated comorbidities for accurate reporting.

Cite this Clinical Reference