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

ICD-10 N39.0

Billable / Specific CC

Urinary tract infection, site not specified

N39
Block
0
Synonyms
132
LCDs
7
Payer Policies
9
Linked CPTs

About ICD-10-CM N39.0

ICD-10-CM code N39.0 represents Urinary tract infection, site not specified. This is a billable/specific code in the Genitourinary System chapter (block N39). The 2026 edition of ICD-10-CM N39.0 became effective on October 1, 2025.

Coding Tips for N39.0

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

N39.0 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 N39.0. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • candidiasis of urinary tract (B37.4-)
  • neonatal urinary tract infection (P39.3)
  • pyuria (R82.81)
  • urinary tract infection of specified site, such as:
  • cystitis (N30.-)
  • pyonephrosis (N13.6)
  • urethritis (N34.-)

Use Additional Code

When coding N39.0, also report these additional codes when applicable.

  • code (B95-B97), to identify infectious agent.

Inpatient DRG Impact, CC

1344:75 codes Urinary tract infection, site not specified. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for N39.0

Local Coverage Determinations (LCDs) from CMS MACs that list N39.0 as a covered diagnosis.

132 LCDs

Showing top 10 of 132 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81227 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81328 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81335 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 0071U →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81383 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81418 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 0073U →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81283 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81408 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81355 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing N39.0.

7 policies

1 Cigna

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

4 Medicare

Billing and Coding: Retroperitoneal Ultrasound
Policy ID: ART-55336
Billing and Coding: Pharmacogenomics Testing
Policy ID: ART-58801
Billing and Coding: Pharmacogenomics Testing
Policy ID: ART-58812
Billing and Coding: Pharmacogenomic Testing
Policy ID: ART-59915

2 Aetna

Fibroid Treatment
Policy ID: CPB-0304
Pancreas Kidney Transplantation
Policy ID: CPB-0587

CPT Codes Commonly Billed with N39.0

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

9 linkages
  • 99202 New patient office visit — fever, headache, abdominal pain, cough, dyspnea, fatigue, dizziness, limb pain, nausea, routine exam, URI, UTI, pharyngitis, otitis, chest pain, weight loss Primary Care
  • 99203 New patient office visit — common complaints plus chronic conditions: HTN, diabetes, hyperlipidemia, asthma, GERD, back pain, migraine, tachycardia, prediabetes Primary Care
  • 99204 New patient office visit — multiple chronic conditions: HTN, T2DM, hyperlipidemia, asthma, anxiety, depression, obesity, IBS, COPD, thyroid, anemia, CAD, sleep apnea, psoriasis, RA Primary Care
  • 99212 Established patient — URI, UTI, pharyngitis, otitis, dermatitis, rash, viral infection, cellulitis, conjunctivitis, sinusitis, bronchitis, ankle sprain Primary Care
  • 99213 Established patient — HTN follow-up, diabetes management, hyperlipidemia, asthma, anxiety, common complaints, back pain, GERD, migraine, acne, joint pain, prediabetes, obesity, anemia, hypothyroid, fatigue Primary Care
  • 81001 Urinalysis with microscopy — UTI, cystitis, dysuria, urinary frequency, abnormal urine, pyelonephritis, chronic pyelonephritis, fever, kidney stone Laboratory
  • 87086 Urine culture — UTI, cystitis, pyelonephritis, abnormal urine, dysuria Laboratory
  • 99282 ED visit level 2 — same as level 1 with low complexity MDM Emergency Medicine
  • 99283 ED visit level 3 — chest pain, dyspnea, pneumonia, UTI, forearm fracture, tibia fracture, syncope, GI bleed Emergency Medicine

Convert N39.0 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
N39.0 5990 00000

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

ICD-10 N39.0, Billing FAQ

Is ICD-10 code N39.0 billable? +

Yes, N39.0 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 N39.0? +

Type 1 Excludes (never code together with N39.0): candidiasis of urinary tract (B37.4-); neonatal urinary tract infection (P39.3); pyuria (R82.81)

Is N39.0 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 CPT codes are commonly billed with N39.0? +

Procedures frequently paired with N39.0 include: 99202, 99203, 99204, 99212, 99213.

What ICD-9 codes does N39.0 map to? +

Per CMS GEMs, N39.0 maps to ICD-9 codes: 5990. 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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