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

ICD-10 N21.0

Billable / Specific

Calculus in bladder

N21
Block
2
Synonyms
0
LCDs
1
Payer Policies
1
Linked CPTs

About ICD-10-CM N21.0

ICD-10-CM code N21.0 represents Calculus in bladder. This is a billable/specific code in the Genitourinary System chapter (block N21). The 2026 edition of ICD-10-CM N21.0 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under N21.0. Per CMS ICD-10-CM Tabular 2026.

  • Calculus in diverticulum of bladder
  • Urinary bladder stone

Type 2 Excludes

Not included here, the excluded code is not part of N21.0, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

  • staghorn calculus (N20.0)

Medicare LCD Coverage for N21.0

Local Coverage Determinations (LCDs) from CMS MACs that list N21.0 as a covered diagnosis.

No Medicare LCDs reference N21.0 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 N21.0.

1 policies

1 Cigna

Nucleic Acid Pathogen Testing - (0530)
Policy ID: MM_0530

CPT Codes Commonly Billed with N21.0

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

1 linkages
  • 52000 Cystoscopy diagnostic — bladder neck obstruction, cystitis, hematuria, hydronephrosis, bladder cancer, BPH, urinary retention, urethral stricture, poor stream, bladder calculus Urology

Convert N21.0 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
N21.0 5940 10000
N21.0 5941 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 N21.0, Billing FAQ

Is ICD-10 code N21.0 billable? +

Yes, N21.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to N21.0? +

ICD-10 N21.0 includes: Calculus in diverticulum of bladder; Urinary bladder stone.

What codes are Type 2 Excludes for N21.0? +

Type 2 Excludes (may be coded together when both conditions exist): staghorn calculus (N20.0)

What CPT codes are commonly billed with N21.0? +

Procedures frequently paired with N21.0 include: 52000.

What ICD-9 codes does N21.0 map to? +

Per CMS GEMs, N21.0 maps to ICD-9 codes: 5940, 5941. 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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