Hematuria and Foley Catheters

This month’s “In the kNOW” blog is going to discuss recent Coding Clinic advice that outlines how to code hematuria when it is caused by a Foley catheter. The advice published in the 2nd Qtr. 2025 Coding Clinic establishes a difference in coding depending on the cause of the hematuria. Was the hematuria caused by trauma during the insertion of the Foley catheter, or did it occur as a result of the Foley being accidentally pulled out by the patient?

Let’s start by looking at the coding that applies when the hematuria is caused by trauma during insertion using this example:

An elderly male was seen in the ER yesterday and had a Foley catheter inserted before being sent back to the nursing home. Today, the patient returns to the ER with gross hematuria necessitating continuous bladder irrigation and Foley replacement. The final diagnosis was gross hematuria due to trauma during the initial Foley catheter insertion. 

Advice from Coding Clinic for appropriate code assignment is as follows:

N99.820    Postprocedural hemorrhage of a genitourinary system organ or structure following a  

                  genitourinary system procedure

Y84.6        Urinary catheterization as the cause of abnormal reaction of the patient, or of later 

                  complication, without mention of misadventure at the time of the procedure

R31.0        Gross hematuria

Since the bleeding was the result of the trauma during the catheter insertion, postprocedural hemorrhage is the correct code.

Our next example provides guidance on coding when a Foley is accidentally pulled out resulting in hematuria. 

A patient was admitted from the ER where, as part of their treatment, a Foley catheter had been placed. Several days later, the patient became very agitated and accidentally pulled out the catheter causing hematuria. 

Code assignment for this will not be the same as the previous example, since this is injury and not the result of a procedure. In this scenario, the coding would be: 

T83.83XA     Hemorrhage due to genitourinary prosthetic devices, implants, and grafts, initial 

                      encounter

R31.9            Hematuria, unspecified

In summation, coding professionals must apply the concepts of postprocedural hemorrhage versus injury in order to arrive at the correct coding when they encounter hematuria due to a Foley catheter. This Coding Clinic advice provides that level of clarity. 

Now you are In the kNOW!!

About the Author

Dianna Foley, RHIA, CCS, CDIP, CHPS, has 25 years of HIM experience. She’s an AHIMA-approved ICD-10-CM/PCS trainer, an AHIMA-published author, a participant in AHIMA credential item writing and exam development, and served on the AHIMA Nominating Committee. She presents on coding topics at the national, state, and regional levels and serves as OHIMA’s Education Coordinator.