N36.1 ICD-10-CM Code: Urethral diverticulum

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for N36.1 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on N36.1 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for N36.1

MedCoder structured workflow — derived from this code’s own official record

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Official instructions as workflow

• Excludes2 — not part of N36.1(3 notes)

  Coding workflow: The conditions named in this note are not included in N36.1. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareO08.8, O23, O75.3, O86.2

  See the official tabular notes · Guidelines I.A.12.b

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Indexed Clinical Terms (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

• Diverticulum, diverticula (multiple), urethra (acquired)
• Sacculation, urethra

Don’t confuse N36.1 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of N36.1 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• N36.9— Specificity relationship (Review)

  Overlapping diagnoses in the same category.

  Overlapping codes in the same category — the documentation decides which is the more specific fit.

  What moves you there: A record that documents no more than “Urethral disorder, unspecified” takes N36.9; specificity in the record moves it back here.

  Full comparison: N36.1 vs N36.9 →

• O00— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of abortion or ectopic or molar pregnancy adds O00; it is not part of this code and both may be reported when both are documented.

  Full comparison: N36.1 vs O00 →

• O07— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of abortion or ectopic or molar pregnancy adds O07; it is not part of this code and both may be reported when both are documented.

  Full comparison: N36.1 vs O07 →

• O08.8— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of abortion or ectopic or molar pregnancy adds O08.8; it is not part of this code and both may be reported when both are documented.

  Full comparison: N36.1 vs O08.8 →

• O23— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of pregnancy, childbirth and the puerperium adds O23; it is not part of this code and both may be reported when both are documented.

  Full comparison: N36.1 vs O23 →

• O75.3— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of pregnancy, childbirth and the puerperium adds O75.3; it is not part of this code and both may be reported when both are documented.

  Full comparison: N36.1 vs O75.3 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Verify Before Coding

• No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 3 MS-DRGs: DRG 698 (MDC 11), DRG 699 (MDC 11), DRG 700 (MDC 11).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):GEN007 — Other specified and unspecified diseases of bladder and urethra (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other specified and unspecified diseases of bladder and urethra).

N35.82 — Other urethral stricture, female, N35.9 — Urethral stricture, unspecified, N35.911 — Unspecified urethral stricture, male, meatal, N35.912 — Unspecified bulbous urethral stricture, male, N35.913 — Unspecified membranous urethral stricture, male, N35.914 — Unspecified anterior urethral stricture, male, N35.916 — Unspecified urethral stricture, male, overlapping sites, N35.919 — Unspecified urethral stricture, male, unspecified site, N35.92 — Unspecified urethral stricture, female, N36.0 — Urethral fistula, N36.2 — Urethral caruncle, N36.41 — Hypermobility of urethra, N36.42 — Intrinsic sphincter deficiency (ISD), N36.43 — Combined hypermobility of urethra and intrinsic sphincter deficiency, N36.44 — Muscular disorders of urethra, N36.5 — Urethral false passage, N36.8 — Other specified disorders of urethra, N36.9 — Urethral disorder, unspecified, N37 — Urethral disorders in diseases classified elsewhere, N99.110 — Postprocedural urethral stricture, male, meatal, +43 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Diverticulum, diverticula”, “Sacculation”; these codes share that main term but sit in a different category of the Tabular List.

I31.8 — Other specified diseases of pericardium (pericardium, acquired), J39.8 — Other specified diseases of upper respiratory tract (trachea), J98.09 — Other diseases of bronchus, not elsewhere classified (bronchus, acquired), K22.5 — Diverticulum of esophagus, acquired (Zenker's), K31.4 — Gastric diverticulum (cardia), K38.2 — Diverticulum of appendix (appendix), K57.90 — Diverticulosis of intestine, part unspecified, without perforation or abscess without bleeding, N28.89 — Other specified disorders of kidney and ureter (ureter), N32.3 — Diverticulum of bladder (bladder), N50.89 — Other specified disorders of the male genital organs (seminal vesicle), N83.8 — Other noninflammatory disorders of ovary, fallopian tube and broad ligament (fallopian tube), Q24.8 — Other specified congenital malformations of heart (heart), Q31.3 — Laryngocele (larynx), Q32.4 — Other congenital malformations of bronchus (bronchus), Q38.7 — Congenital pharyngeal pouch (pharynx), Q39.6 — Congenital diverticulum of esophagus (esophagus), Q40.2 — Other specified congenital malformations of stomach (stomach, congenital), Q43.0 — Meckel's diverticulum (displaced) (hypertrophic) (Meckel's), Q43.8 — Other specified congenital malformations of intestine (cecum, congenital), Q62.8 — Other congenital malformations of ureter (ureter, congenital), +2 more

Contextual Map

Every relationship of N36.1 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

• N00-N99 — Chapter 14: Diseases of the Genitourinary System (N00-N99) (N00-N99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• N30-N39 — Other diseases of the urinary system[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Clinical classification (CCSR)

• GEN007 — Other specified and unspecified diseases of bladder and urethra[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

MS-DRG Grouper

• DRG 698 — OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC[MS-DRG]: “OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC (MDC 11)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 699 — OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC[MS-DRG]: “OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC (MDC 11)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 700 — OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC[MS-DRG]: “OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC (MDC 11)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

• MDC 11 — Diseases and Disorders of the Kidney and Urinary Tract[MDC crossing]: “Diseases and Disorders of the Kidney and Urinary Tract — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 3,574 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

• Diverticulum, diverticula (multiple), urethra (acquired)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Sacculation, urethra[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (11)

• N36 — Other disorders of urethra[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• N36.0 — Urethral fistula[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• N36.2 — Urethral caruncle[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• N36.4 — Urethral functional and muscular disorders[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• N36.41 — Hypermobility of urethra[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• N36.42 — Intrinsic sphincter deficiency (ISD)[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• N36.43 — Combined hypermobility of urethra and intrinsic sphincter deficiency[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• N36.44 — Muscular disorders of urethra[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 3 more

Change history

• FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Inpatient payment groups Official source data

CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to N36.1 in its code family, with their registry titles.

• N36 — Other disorders of urethra
• N36.0 — Urethral fistula
• N36.2 — Urethral caruncle
• N36.4 — Urethral functional and muscular disorders
• N36.41 — Hypermobility of urethra
• N36.42 — Intrinsic sphincter deficiency (ISD)
• N36.43 — Combined hypermobility of urethra and intrinsic sphincter deficiency
• N36.44 — Muscular disorders of urethra
• N36.5 — Urethral false passage
• N36.8 — Other specified disorders of urethra

View all codes in the N36 family