Health data standards and systems

Could VICC please confirm the correct code/s to assign for Pyelonephritis with renal calculus and hydronephrosis with an infection?

ACCD advice TN200 Pyelonephritis with renal calculus and hydronephrosis retired 30th June 2017 suggested to code both N13.2 Hydronephrosis with renal and ureteral calculus obstruction and N13.6 Pyonephrosis when an infection is present.

Please also refer to the excludes note at N13.0 – N13.5 ‘Excludes: with infection (N13.6)’ that has been on these codes since First Edition.

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ACCD Coding Rule TN200 (Retired 30 June 2017)
VICC 2263
Tabular List

For documentation of pyelonephritis with renal calculus and hydronephrosis with infection, VICC advises to firstly follow the ICD-10-AM Alphabetic Index lead term Pyelonephritis/with calculus/with hydronephrosis. This leads to N13.2 Hydronephrosis with renal and ureteral calculus obstruction. Then follow the Excludes note ‘with infection’ to assign N13.6 Pyonephrosis. The same code (N13.6) is reached if Index lead terms of calculus or hydronephrosis are used.

VICC notes that pyelonephritis is an inclusion term for codes in N10–N16 Renal tubulo-interstitial diseases and an additional code should not be assigned. Therefore N13.6 Pyonephrosis is the only code to assign.