Crystal's MCW Coder HubLITHIASIS - Medical Keyword Reference
Lithiasis is the formation or presence of stone-like deposits (calculi) within internal organs or ducts of the body.[^1][^2][^3]
Short and Long Definitions
Short definition Lithiasis is the process of forming calculi (stones) in internal organs, particularly the urinary tract, gallbladder, or salivary glands.[^2][^3]
Long definition Lithiasis refers to the pathological formation of mineral and acid salt concretions (calculi or stones) within hollow organs or ducts, occurring when supersaturation of solutes leads to crystallization and aggregation into solid masses; most commonly affects the urinary system (nephrolithiasis, urolithiasis), hepatobiliary system (cholelithiasis, choledocholithiasis), salivary glands (sialolithiasis), and less commonly pancreas, bronchi, or joints; composition varies by location (calcium oxalate/phosphate in kidneys, cholesterol/bilirubin in gallbladder, calcium phosphate in salivary glands); clinical manifestations range from asymptomatic incidental findings to severe colicky pain, obstruction, infection, and organ dysfunction; diagnosis via imaging (ultrasound, CT, plain radiography); treatment includes conservative management (hydration, pain control), medical dissolution therapy, extracorporeal shock wave lithotripsy (ESWL), endoscopic extraction, or surgical removal.[^3][^4][^6][^1][^2]
Etymology
- Lith-: Greek líthos (λίθος) = “stone, rock.”
- -iasis: Greek suffix -íasis (-ίασις) = “condition, pathological state, disease process.”
- Literal: “Stone condition” or “presence of stones.”
- Historical: From Late Latin lithiāsis, borrowed from Greek lithíāsis (suffering from calculi), circa 1657.[^5][^1][^2]
Classification by Anatomic Location
| Type | Location | Common Stone Composition |
|---|---|---|
| Nephrolithiasis | Kidney (renal pelvis/calyces) | Calcium oxalate (70-80%), calcium phosphate, uric acid, struvite, cystine.[^7] |
| Urolithiasis | Urinary tract (general term) | Same as nephrolithiasis. |
| Ureterolithiasis | Ureter | Migrated kidney stones. |
| Cystolithiasis | Urinary bladder | Calcium oxalate, uric acid, struvite. |
| Urethrolithiasis | Urethra | Rare; migrated bladder stones. |
| Cholelithiasis | Gallbladder | Cholesterol (80%), pigmented (bilirubin), mixed.[^2][^6] |
| Choledocholithiasis | Common bile duct | Migrated gallstones or primary duct stones.[^6] |
| Cholecystolithiasis | Gallbladder (synonym for cholelithiasis) | Cholesterol, pigmented. |
| Sialolithiasis | Salivary glands/ducts (submandibular 80-90%) | Calcium phosphate/carbonate. |
| Pancreatolithiasis | Pancreatic ducts | Calcium carbonate (chronic pancreatitis). |
| Broncholithiasis | Bronchi | Calcified material from lymph nodes. |
| Dacryolithiasis | Lacrimal/tear ducts | Calcium deposits.[^6] |
Coding Context
ICD-10-CM (by Location):
| Code | Description |
|---|---|
| N20.0 | Calculus of kidney (nephrolithiasis, renal stone). |
| N20.1 | Calculus of ureter (ureterolithiasis). |
| N20.2 | Calculus of kidney with calculus of ureter. |
| N20.9 | Urinary calculus, unspecified (urolithiasis). |
| N21.0 | Calculus in bladder (cystolithiasis). |
| N21.1 | Calculus in urethra. |
| K80.0 | Calculus of gallbladder with acute cholecystitis. |
| K80.2 | Calculus of gallbladder without cholecystitis (cholelithiasis). |
| K80.5 | Calculus of bile duct without cholangitis/cholecystitis (choledocholithiasis). |
| K11.5 | Sialolithiasis (calculus of salivary gland/duct). |
| K86.81 | Exocrine pancreatic insufficiency (includes pancreatolithiasis context). |
CPT Codes (Treatment Procedures):
| Code | Description |
|---|---|
| 50060 | Nephrolithotomy; removal of kidney stone, complicated. |
| 50080 | Percutaneous nephrolithotomy ≤2 cm. |
| 50081 | Percutaneous nephrolithotomy >2 cm or complex. |
| 50590 | Lithotripsy, extracorporeal shock wave (ESWL). |
| 52310-52315 | Cystourethroscopy with removal ureteral/renal calculus. |
| 47564 | Laparoscopic cholecystectomy with exploration common duct (choledocholithiasis). |
| 43264 | ERCP with endoscopic retrograde removal stone(s) from biliary/pancreatic ducts. |
| 42330-42340 | Sialolithotomy (removal salivary duct stone). |
Related Terms
- Calculus (pl. calculi): Medical term for stone.[^2][^3]
- Concretion: Hardened mass formed by mineral deposition.
- Renal colic: Severe flank pain from ureteral stone obstruction.[^7]
- Hydronephrosis: Kidney swelling from obstructed urine flow.
- ESWL: Extracorporeal shock wave lithotripsy (non-invasive stone fragmentation).
- Lithotripsy: Stone fragmentation technique.
- Lithotomy: Surgical removal of stone.
- Staghorn calculus: Large branching kidney stone filling renal pelvis.
- Microlithiasis: Presence of very small stones/calcifications.[^2]
- Hypocitraturic nephrolithiasis: Kidney stones due to low urinary citrate.[^7]
Pathophysiology
Stone formation mechanisms:
- Supersaturation: Urine/fluid becomes oversaturated with stone-forming substances.
- Nucleation: Crystal formation begins.
- Aggregation: Crystals cluster together.
- Growth: Stones enlarge over time.
- Retention: Anatomic abnormalities prevent stone passage.
Risk factors (nephrolithiasis):[^7]
- Dehydration, low fluid intake.
- Diet high in sodium, animal protein, oxalate.
- Metabolic disorders (hyperparathyroidism, gout, cystinuria).
- Anatomic abnormalities (medullary sponge kidney).
- Chronic UTIs (struvite stones).
- Medications (calcium/vitamin D supplements, diuretics).
- Family history.
Clinical Features
Nephrolithiasis/Urolithiasis symptoms:[^7]
- Renal colic: Sudden severe flank pain radiating to groin/inner thigh.
- Restlessness, inability to find comfortable position.
- Nausea, vomiting, diaphoresis.
- Hematuria (gross or microscopic).
- Dysuria, frequency, urgency (bladder stones).
- Complications: Hydronephrosis, obstructive pyelonephritis, sepsis, chronic kidney disease.
Cholelithiasis symptoms:
- Asymptomatic (80% “silent stones”).
- Biliary colic (RUQ pain post-fatty meal).
- Cholecystitis (fever, positive Murphy’s sign).
- Jaundice (if bile duct obstruction).
Sialolithiasis symptoms:
- Painful swelling of affected gland (especially with eating).
- Recurrent sialadenitis.
- Palpable stone in duct.
Diagnostic Workup
Imaging:
- Non-contrast CT (gold standard for urolithiasis): Sensitivity >95%, identifies stone size/location.[^7]
- Ultrasound: First-line for cholelithiasis, safe in pregnancy.
- Plain radiography (KUB): Detects radiopaque stones (70-80% calcium-based).
- ERCP/MRCP: Choledocholithiasis visualization.
Laboratory:
- Urinalysis: Hematuria, crystalluria, pH.
- Metabolic workup: Calcium, uric acid, phosphate, parathyroid hormone (recurrent stones).
- 24-hour urine collection: Volume, calcium, oxalate, citrate, uric acid.
Management and Treatment
Conservative (small stones <5 mm):
- Hydration (2-3 L/day).
- Pain control (NSAIDs, opioids).
- Medical expulsive therapy (alpha-blockers: tamsulosin).
- Observation (70-80% pass spontaneously).
Interventional (>5 mm, symptomatic, obstructive):
- ESWL (50590): Shock waves fragment stones; first-line for <2 cm renal stones.
- Ureteroscopy (URS): Endoscopic retrieval/laser lithotripsy.
- PCNL (50080/81): Percutaneous access for large/complex renal stones.
- Cholecystectomy: Definitive treatment for symptomatic cholelithiasis.
- ERCP with sphincterotomy (43264): Choledocholithiasis stone extraction.
Prevention (recurrent nephrolithiasis):
- Increase fluid intake (>2.5 L/day).
- Dietary modification (reduce sodium, animal protein, oxalate).
- Citrate supplementation (potassium citrate).
- Thiazide diuretics (hypercalciuria).
Epidemiology
- Nephrolithiasis: Lifetime prevalence 10-15%; recurrence rate 50% within 5-10 years.[^7]
- Cholelithiasis: Affects 10-15% adults in Western countries; “4 F’s” (female, forty, fat, fertile).
- Sialolithiasis: 80-90% submandibular gland (higher calcium concentration, thicker saliva).
One-Sentence Summary
Lithiasis (Greek lith-iasis “stone condition,” circa 1657), pathological calculus formation in kidneys (N20.0 nephrolithiasis), gallbladder (K80.2 cholelithiasis), ducts, or glands from supersaturation/crystallization, presenting with colicky pain/obstruction, diagnosed via CT/ultrasound, treated conservatively (hydration) or interventionally (ESWL 50590, PCNL 50080-81, cholecystectomy, ERCP 43264).
Document created: February 13, 2026 Medical coding professional reference
Med roots Appendix A Prefixes Appendix B Combining Forms Appendix C Suffixes Appendix D Suffix forms