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Renal Stone Disease K003

Last amended 
4 July 2019
Current RMA Instruments

Reasonable Hypothesis SOP

69 of 2019

Balance of Probabilities SOP

70 of 2019

Changes from previous Instruments

SOP Bulletin 209

ICD Coding
  • ICD-9-CM Codes: 274.11,592.0,592.1
  • ICD-10-AM Codes: N20.0, N20.1, N20.2
Brief description

This SOP covers stones (calculi) in the kidney or ureter.

Confirming the diagnosis

Diagnosis requires confirmation with either radiological imaging (CT scan, ultrasound) of the kidneys and ureters, or passage of gravel or stone/s in the urine.  The diagnosis can be made by a general practitioner.

The relevant medical specialist is a nephrologist or urologist.

Additional diagnoses covered by SOP
  • Kidney stone
  • Nephrolithiasis
  • Renal calculus
  • Staghorn calculus
  • Ureteric calculus
  • Ureterolithiasis
Conditions excluded from SOP
  • Cholelithiasis (gallstones)*
  • Bladder stones (primary) #
  • Nephrocalcinosis #

* another SOP applies

# non-SOP condition

Clinical onset

Patients may present with the classic symptoms of renal colic and hematuria (blood in the urine). Others may be asymptomatic or have atypical symptoms such as vague abdominal pain, acute abdominal or flank pain, nausea, urinary urgency or frequency, or difficulty urinating.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  Treatment may include conservative measures, non-invasive lithotripsy or surgical measures to remove stones and evaluation for underlying causes.