Part B Insider (Multispecialty) Coding Alert

Published on Mon Dec 08, 2014 PDF

Question: Our physician reported interstitial cystitis in a patient who had hematuria. How can we code for this diagnosis? What will be the ICD-10-CM options for us in the next year?

Answer: The ICD-9-CM code for interstitial cystitis is 595.1 (Chronic interstitial cystitis). ICD-9-CM has no specific options for the presentation of hematuria. 

ICD-10-CM: When your diagnosis coding changes, you will have two new diagnoses. They are:

• N30.10, Interstitial cystitis (chronic) without hematuria
• N30.11, Interstitial cystitis (chronic) with hematuria

You’ll choose between N30.10 and N30.11 based on whether the patient has hematuria. 

Navigating the alphabetical index: Here’s how to find your codes in the Alphabetic Index:

Cystitis: N30.90 (Cystitis, unspecified without hematuria)

- chronic N30.20
- - interstitial N30.10
- - - with hematuria N30.11

Coding tips: Under the notes for the category N30 (Cystitis), you’ll see “use additional code to identify infectious agent (B95-B97).” That means you should include a secondary diagnosis for the bacteria or virus that is causing the cystitis if it is known. Also, an Excludes1 note lists prostatocystitis (N41.3). That means do not code N41.3 with either of these diagnoses (N30.10 or N30.11). 

What is interstitial cystitis? Interstitial cystitis is an inflammation of the bladder wall which may be long-term or chronic. Your physician will investigate a patient with interstitial cystitis for bladder infections and even bladder cancer. Interstitial cystitis may present as hematuria, i.e. appearance of red blood cells in urine. 

Your physician will diagnose with interstitial cystitis after ruling out various conditions. Also, you may code an interstitial cystitis code when the provider documents “Hunner’s ulcer,” “panmural fibrosis of bladder,” or “submucous cystitis.”