ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 N20

Non-Billable Header

Calculus of kidney and ureter

N20
Block
1
Synonyms
0
LCDs
0
Payer Policies
0
Linked CPTs

About ICD-10-CM N20

ICD-10-CM code N20 represents Calculus of kidney and ureter. This is a non-billable header code in the Genitourinary System chapter (block N20). The 2026 edition of ICD-10-CM N20 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under N20. Per CMS ICD-10-CM Tabular 2026.

  • Calculous pyelonephritis

Type 1 Excludes

Pure excludes, these codes can never be coded together with N20. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • nephrocalcinosis (E83.59)
  • that with hydronephrosis (N13.2)

Medicare LCD Coverage for N20

Local Coverage Determinations (LCDs) from CMS MACs that list N20 as a covered diagnosis.

No Medicare LCDs reference N20 as covered

This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.

Commercial Payer Coverage

Coverage policies from major commercial payers referencing N20.

No commercial payer policies reference N20 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but N20 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with N20

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for N20

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.

ICD-10 N20, Billing FAQ

Is ICD-10 code N20 billable? +

No, N20 is a non-billable header code. Use a more specific child code from block N20 when submitting claims.

What other names or terms map to N20? +

ICD-10 N20 includes: Calculous pyelonephritis.

What codes are Type 1 Excludes for N20? +

Type 1 Excludes (never code together with N20): nephrocalcinosis (E83.59); that with hydronephrosis (N13.2)

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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