ICD-10 · PDGM grouping
N13 Obstructive and reflux uropathy
All 18 codes in the N13 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
18
Can lead a claim
16
Cannot lead a claim
2
What CMS assigns to N13
16 of the 18 codes group to MMTA - Gastrointestinal tract and Genitourinary system (15) and MMTA - Other (1); 2 are assigned no clinical group. 1 of the 18 counts toward the Other disorders of the kidney and ureter, excluding chronic kidney disease and ESRD comorbidity subgroup; 17 are assigned none. 16 of the 18 can lead a claim. CMS attaches a code-first note to 1 of the 18.
- Other disorders of the kidney and ureter, excluding chronic kidney disease and ESRD: counts toward the high comorbidity tier only in an interaction pair.
Code first
CMS grouper convention 135, on N13.8. Code first:
- , if applicable, any causal condition, such as:
- enlarged prostate (N40.1)
Every code in N13
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| N13.0 | Hydronephrosis with ureteropelvic junction obstruction | Can lead a claim | J | None |
| N13.1 | Hydronephrosis with ureteral stricture, not elsewhere classifiedCMS: Hydronephrosis w ureteral stricture, NEC | Can lead a claim | J | None |
| N13.2 | Hydronephrosis with renal and ureteral calculous obstruction | Can lead a claim | J | Other disorders of the kidney and ureter, excluding chronic kidney disease and ESRD |
| N13.3 Other and unspecified hydronephrosis | ||||
| N13.30 | Unspecified hydronephrosis | Can lead a claim | J | None |
| N13.39 | Other hydronephrosis | Can lead a claim | J | None |
| N13.4 | Hydroureter | Can lead a claim | J | None |
| N13.5 | Crossing vessel and stricture of ureter without hydronephrosisCMS: Crossing vessel and stricture of ureter w/o hydronephrosis | Can lead a claim | J | None |
| N13.6 | Pyonephrosis | Can lead a claim | J | None |
| N13.7 Vesicoureteral-reflux | ||||
| N13.70 | Vesicoureteral-reflux, unspecified | Can lead a claim | J | None |
| N13.71 | Vesicoureteral-reflux without reflux nephropathy | Can lead a claim | J | None |
| N13.72 Vesicoureteral-reflux with reflux nephropathy without hydroureter | ||||
| N13.721 | Vesicoureteral-reflux with reflux nephropathy without hydroureter, unilateralCMS: Vesicoureter-reflux w reflux nephrop w/o hydrourt, unil | Can lead a claim | J | None |
| N13.722 | Vesicoureteral-reflux with reflux nephropathy without hydroureter, bilateralCMS: Vesicoureter-reflux w reflux nephrop w/o hydrourt, bi | Can lead a claim | J | None |
| N13.729 | Vesicoureteral-reflux with reflux nephropathy without hydroureter, unspecifiedCMS: Vesicoureter-reflux w reflux nephropathy w/o hydrourt, unsp | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| N13.73 Vesicoureteral-reflux with reflux nephropathy with hydroureter | ||||
| N13.731 | Vesicoureteral-reflux with reflux nephropathy with hydroureter, unilateralCMS: Vesicoureter-reflux w reflux nephrop w hydrourt, unil | Can lead a claim | A | None |
| N13.732 | Vesicoureteral-reflux with reflux nephropathy with hydroureter, bilateralCMS: Vesicoureter-reflux w reflux nephrop w hydrourt, bilateral | Can lead a claim | J | None |
| N13.739 | Vesicoureteral-reflux with reflux nephropathy with hydroureter, unspecifiedCMS: Vesicoureter-reflux w reflux nephropathy w hydroureter, unsp | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| N13.8 | Other obstructive and reflux uropathy | Can lead a claim, code first applies | J | None |
| N13.9 | Obstructive and reflux uropathy, unspecified | Can lead a claim | J | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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