ICD-10 N13.1
Billable / Specific CCHydronephrosis with ureteral stricture, not elsewhere classified
About ICD-10-CM N13.1
ICD-10-CM code N13.1 represents Hydronephrosis with ureteral stricture, not elsewhere classified. This is a billable/specific code in the Genitourinary System chapter (block N13). The 2026 edition of ICD-10-CM N13.1 became effective on October 1, 2025.
Coding Tips for N13.1
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
N13.1 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Type 1 Excludes
Pure excludes, these codes can never be coded together with N13.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- Hydronephrosis with ureteral stricture with infection (N13.6)
Inpatient DRG Impact, CC
codes Hydronephrosis with ureteral stricture, not elsewhere classified. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for N13.1
Local Coverage Determinations (LCDs) from CMS MACs that list N13.1 as a covered diagnosis.
Showing top 10 of 31 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing N13.1.
4 Medicare
1 Aetna
CPT Codes Commonly Billed with N13.1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert N13.1 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| N13.1 | 591 | 10111 |
| N13.1 | 5933 | 10112 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To N13.1
Other codes in section N10-N16 (Renal tubulo-interstitial diseases).
ICD-10 N13.1, Billing FAQ
Is ICD-10 code N13.1 billable? +
Yes, N13.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What codes are Type 1 Excludes for N13.1? +
Type 1 Excludes (never code together with N13.1): Hydronephrosis with ureteral stricture with infection (N13.6)
Is N13.1 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What ICD-9 codes does N13.1 map to? +
Per CMS GEMs, N13.1 maps to ICD-9 codes: 591, 5933. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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