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Renal Stone Disease K003
In this section
Current RMA Instruments:
|Reasonable Hypothesis SOP||65 of 2010|
|Balance of Probabilities SOP||66 of 2010|
Changes from Previous Instruments:
- CD-9-CM Codes: 274.11,592.0,592.1
- ICD-10-AM Codes: N20.0, N20.1, N20.2
This SOP covers stones (calculi) in the kidney or ureter.
Is specific diagnostic evidence required to apply either SOP? – No.
Are there sub-factors that require specific information? – Yes.
There is one factor specific to staghorn calculi (ammonium phosphate stones) only.
Additional diagnoses covered by SOP
- Kidney stone
- Renal calculus
- Staghorn calculus
- Ureteric calculus
Conditions not covered by SOP
- Cholelithiasis (gallstones), ICD code 574
- Bladder stones (primary), ICD codes 594
If, after applying the above information, you are unable to confirm the diagnosis, you should then:
- seek medical officer advice about further investigation, or;
- generate a diagnostic report, or;
- re-encode the condition, if appropriate.
The following may be useful in establishing the diagnosis:
- Report from treating doctor
- Report of imaging procedure (X-Ray, Ultrasound)