ICD-10 N99.528
Billable / Specific HCC v28: 176Other complication of incontinent external stoma of urinary tract
About ICD-10-CM N99.528
ICD-10-CM code N99.528 represents Other complication of incontinent external stoma of urinary tract. This is a billable/specific code in the Genitourinary System chapter (block N99). The 2026 edition of ICD-10-CM N99.528 became effective on October 1, 2025.
Coding Tips for N99.528
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
N99.528 is a CMS-HCC v28 risk-adjustment code (category 176). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Medicare LCD Coverage for N99.528
Local Coverage Determinations (LCDs) from CMS MACs that list N99.528 as a covered diagnosis.
Showing top 9. Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing N99.528.
1 Medicare
CPT Codes Commonly Billed with N99.528
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 N99.528 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 |
|---|---|---|
| N99.528 | 9975 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To N99.528
Other codes in section N99 (Intraoperative and postprocedural complications and disorders of genitourinary system, not elsewhere classified).
ICD-10 N99.528, Billing FAQ
Is ICD-10 code N99.528 billable? +
Yes, N99.528 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does N99.528 affect Medicare Advantage HCC risk adjustment? +
Yes. N99.528 maps to CMS-HCC v28 category 176. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does N99.528 map to? +
Per CMS GEMs, N99.528 maps to ICD-9 codes: 9975. 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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