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An Overview of the Genitourinary System

The genitourinary system includes the reproductive and the urinary excretion organs. These are grouped together because of their proximity to each other.

The structure of the urinary tract includes the kidneys; two ureters, which are the tubes leading from the kidney to the bladder and the urethra, which is the tube leading from the bladder to the exterior of the body. The anatomy differs between men and women.

In the female, the urethra is between one or two inches long, and exits the body between the clitoris and the vagina. The internal reproductive organs include the vagina, uterus, ovaries, and fallopian tubes, and it is designed to carry out several functions such as reproduction.

Breasts are also included in this chapter, but only female breasts develop, this occurs during puberty; female sex hormones (estrogen) promotes breast development.

In the male, the urethra is about eight inches long and opens at the end of the penis. The urethra also provides an exit for the semen during the ejaculation. The internal genital organs include the testes, the epididymis, ductus deferens, and the ejaculatory duct. Associated glands include the prostate and seminal bulbo-urethral glands.

Diseases of the Genitourinary System

Combinations

Along with the detailed anatomy for this chapter there are some very detailed codes that combine disease process with symptoms. Some examples are:

N02.1 Recurrent and persistent hematuria with focal and segmental glomerular lesions

N06.7 Isolated proteinuria with diffuse crescentic glomerulonephritis

N30.01 Acute cystitis with hematuria

Laterality

Although we are dealing with anatomy that has laterality, the only codes in this chapter that specify right and left are in category N60 for breast cysts. It will be required to document which breast (right or left) or if both breasts are affected by the disease or condition.

Guidelines

The small amount of guidelines for this chapter all pertain to Chronic Kidney Disease (CKD) and parallel the guidelines from ICD-9. CKD is coded using category N18, all codes in this category require a 4th character. The 4th character is representative of the stage of CKD, for example: N18.3 is CKD, stage 3 (moderate).

Tabular specific guidelines instruct to code first any associated diabetic CKD (E08.22, E09.22, E10.22, E11.22, E13.22) or hypertensive CKD (I12.-,I13.-). Also use an additional code to identify kidney transplant status, if applicable (Z94.0). N18.6 for end stage renal disease has an additional use additional code note to identify dialysis status (Z99.2).

Tabular guidelines always take precedence over the general guidelines posted in the front of the manual.

Expanded Codes

As with other chapters in ICD-10 the Genitourinary System chapter has been expanded to include a specific section involving Intraoperative and postprocedural complications. Some examples from category N99 are:

N99.110 Postprocedural urethral stricture, male meatal

N99.520 Hemorrhage of other external stoma of urinary tract

N99.821 Postprocedural hemorrhage and hematoma of a genitourinary system organ or structure following other procedure.

ICD-10 also will require that physicians identify the symptoms of Menopause.

ICD-9 

627.2 Symptomatic Menopausal or female climacteric sates.

ICD-10

N95.1 Menopausal and female climacteric states

Use additional code for associated symptoms, such as:

N95.1 Insomnia

R45.4 Irritability

Use caution when looking up some of the conditions for this chapter as the Alphabetic Index does not always lead you directly to the correct combination code. Remember even though laterality abounds in ICD-10 it is not applied to many genitourinary codes. Consider yourself enlight10’d!