Revenue Cycle Insider

Question: A patient presented with symptoms of a urinary tract infection (UTI) and the provider documented a diagnosis of UTI due to candida yeast. When I submitted a claim, the diagnosis code of N39.0 was denied. What code should I have used?

Pennsylvania Subscriber

Answer: According to the ICD-10-CM guidelines, code N39.0 (Urinary tract infection, site not specified) specifies that the causative agent should be reported but has an Excludes1 note for situations where the UTI is caused by candidiasis.

In such situations, you should look instead to B37.4- (Candidiasis of other urogenital sites). There’s the option to report a 5^th character that further specifies the location, such as cystitis (infection or inflammation of the bladder) or urethritis (infection or inflammation of the urethra) if the documentation supports more specificity.

Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC