N28.86 - Ureteritis Cystica

Short Description

N28.86: Use for ureteritis cystica - a rare, typically benign condition characterized by the formation of multiple small, fluid-filled cysts within the walls of the ureter. These submucosal cysts develop due to chronic inflammation, most commonly from recurrent urinary tract infections, chronic irritation, urinary stones, or long-term catheterization.

Full Description & Clinical Context

N28.86 - Ureteritis cystica describes a non-neoplastic lesion of the ureter characterized by multiple submucosal small cysts in the ureteral wall, caused by inflammation from urinary tract stones or infection.

Key Clinical Features:

Rare condition - uncommon diagnosis
Cystic changes - multiple small fluid-filled cysts in ureter wall
Benign nature - not cancerous, but requires monitoring
Inflammatory origin - develops from chronic irritation/infection
Usually asymptomatic - often incidental finding on imaging
Submucosal location - cysts form beneath the mucosal lining

Pathophysiology: Ureteritis cystica develops when chronic inflammation of the ureteral mucosa leads to the formation of small cystic spaces within the ureteral wall. The exact mechanism is not fully understood, but it is believed to involve:

Chronic irritation from infection, stones, or obstruction
Inflammatory changes in the ureteral lining
Formation of submucosal cysts (von Brunn’s nests become cystic)
Cysts filled with clear fluid
Can occur anywhere along the ureter
Usually bilateral but can be unilateral

Common causes/risk factors:

Chronic urinary tract infections (UTIs) - most common association
Long-term catheterization - chronic irritation
Ureteral obstructions - from stones, strictures, tumors
History of kidney stones - chronic stone passage
Recurrent pyelonephritis
Chronic instrumentation of urinary tract

Clinical significance:

Usually benign and asymptomatic
Rarely causes significant obstruction
Can mimic other ureteral pathology on imaging
Important to distinguish from urothelial carcinoma
May be found incidentally during imaging for other reasons
Generally has good prognosis with monitoring

Common symptoms (if present):

Often asymptomatic (most common presentation)
Occasional hematuria (blood in urine) - microscopic or gross
Flank pain (rarely)
Urinary tract infection symptoms (if concurrent infection)
Renal colic (if obstruction occurs)

Code Details

Code set: ICD-10-CM
Full code: N28.86
Title: Ureteritis cystica
Code type: Billable/specific diagnosis code
Clinical category: Other disorders of kidney and ureter, not elsewhere classified
Parent code: N28.8 (Other specified disorders of kidney and ureter)
Grandparent code: N28 (Other disorders of kidney and ureter, not elsewhere classified)
ICD-9-CM equivalent: 590.3 - Pyeloureteritis cystica (approximate mapping)

Coding notes from N28.8 (parent):

Excludes1:
- Hydroureter → N13.4
- Ureteric stricture with hydronephrosis → N13.1
- Ureteric stricture without hydronephrosis → N13.5

Approximate synonyms/terms:

Infective ureteritis
Ureteritis (when cystic type)

Clinical classification:

CCSR Category Code: GEN006
Category: Other specified and unspecified diseases of kidney and ureters
Inpatient Default CCSR: Yes
Outpatient Default CCSR: Yes

The N28 family includes THREE distinct cystic conditions:

Code	Condition	Location	Key Feature
N28.84	Pyelitis cystica	Renal pelvis only	Cysts in renal pelvis
N28.85	Pyeloureteritis cystica	Renal pelvis + ureter	Cysts in BOTH locations
N28.86	Ureteritis cystica	Ureter only	Cysts in ureter ONLY ← YOU ARE HERE

Critical coding distinction:

N28.84 = Renal pelvis ONLY
N28.85 = Renal pelvis AND ureter (both involved)
N28.86 = Ureter ONLY
Documentation must specify location to determine correct code

Note: ICD-9-CM 590.3 (Pyeloureteritis cystica) maps to N28.85, but N28.86 is more specific for ureter-only involvement.

Complete N28 Family - Other Kidney/Ureter Disorders

Code	Description	Key Feature
N28.0	Ischemia and infarction of kidney	Blood flow compromise
N28.1	Cyst of kidney, acquired	Acquired kidney cyst
N28.8-	Other specified disorders	Parent category
N28.81	Hypertrophy of kidney	Kidney enlargement
N28.82	Megaloureter	Dilated ureter
N28.83	Nephroptosis	Dropped/mobile kidney
N28.84	Pyelitis cystica	Cysts in renal pelvis
N28.85	Pyeloureteritis cystica	Cysts in pelvis + ureter
N28.86	Ureteritis cystica	Cysts in ureter ← YOU ARE HERE
N28.89	Other specified disorders	Other
N28.9	Disorder of kidney and ureter, unspecified	Unspecified

When to Use N28.86

Use N28.86 ONLY when:

Ureteritis cystica documented:
- Explicit diagnosis of “ureteritis cystica” OR
- Imaging/pathology report describes cystic changes in ureter wall
- Biopsy confirms cystic ureteritis
Location is ureter ONLY:
- Cysts involve ureter, NOT renal pelvis
- If both renal pelvis and ureter involved → use N28.85
- If only renal pelvis involved → use N28.84
Not excluded conditions:
- NOT hydroureter (N13.4)
- NOT ureteric stricture (N13.1 or N13.5)
- NOT ureteral tumor/neoplasm (code as neoplasm)
Appropriate clinical context:
- History of recurrent UTIs, stones, or chronic irritation
- Imaging shows characteristic cystic changes
- Benign process confirmed

Typical scenarios for N28.86:

“CT urogram shows multiple small cysts in the ureteral wall consistent with ureteritis cystica”
“Ureteroscopy reveals cystic changes in distal ureter; biopsy confirms ureteritis cystica”
“Incidental finding of ureteritis cystica on imaging for kidney stones”

When NOT to Use N28.86

Do NOT use N28.86 when:

Scenario	Use Instead	Why
Cysts in renal pelvis only	N28.84 (Pyelitis cystica)	Different location
Cysts in BOTH pelvis and ureter	N28.85 (Pyeloureteritis cystica)	Both locations involved
Hydroureter	N13.4	Dilated ureter from obstruction
Ureteric stricture	N13.1 or N13.5	Narrowing/stricture
Urothelial carcinoma	C66.x (malignancy) or D41.2x (benign)	Neoplasm, not cystic condition
Simple ureteritis (non-cystic)	N28.89	Inflammation without cysts
Megaloureter	N28.82	Dilated ureter

Critical distinction:

Ureteritis cystica (N28.86) = benign cystic changes
Urothelial carcinoma can mimic ureteritis cystica on imaging → biopsy may be needed

Documentation Requirements for N28.86

MINIMUM documentation needed to assign N28.86:

✅ MUST include:

“Ureteritis cystica” documented OR imaging/pathology describes cystic changes in ureter:
- Provider diagnosis, radiology report, or pathology report
- Cystic lesions in ureter wall
Location specified as URETER (not renal pelvis):
- Cysts in ureter only
- If renal pelvis involved too → N28.85
- If only renal pelvis → N28.84
Benign process:
- Not malignancy
- May need biopsy to confirm benign nature

❌ CANNOT use if:

Only renal pelvis involved (use N28.84)
Both renal pelvis and ureter involved (use N28.85)
Urothelial carcinoma diagnosed (code as neoplasm)
Simple hydroureter without cystic changes (use N13.4)

✅ SHOULD document (best practice):

Location (which ureter: right, left, or bilateral)
Extent (proximal, mid, distal ureter)
Size and number of cysts (if visible on imaging)
Associated findings (hydronephrosis, stones, stricture)
Underlying cause (chronic UTI, stones, catheterization)
Diagnostic method (CT, MRI, ureteroscopy, biopsy)
Whether symptomatic or incidental finding
Treatment plan (observation vs intervention)

Clinical Evaluation

Typical workup when ureteritis cystica suspected or diagnosed:

History:

History of recurrent UTIs
History of kidney stones
Prior urologic instrumentation or surgery
Long-term catheterization history
Symptoms (hematuria, flank pain, or asymptomatic)
Duration of symptoms

Physical examination:

Usually normal
Costovertebral angle tenderness (if concurrent infection)
Abdominal/flank examination

Diagnostic studies:

Imaging (diagnostic):

CT Urography (gold standard):
- Multiple small filling defects in ureter
- Submucosal cystic lesions
- Characteristic “cobblestone” or “beaded” appearance
- Rules out obstruction, stones, masses
- Can distinguish from tumor
Intravenous Pyelogram (IVP):
- Multiple small filling defects
- “Halo” or “ring” sign around cysts
- Less commonly used now (CT preferred)
Retrograde Pyelogram:
- If CT contraindicated
- Direct visualization of ureter
- Shows filling defects
Renal/ureteral ultrasound:
- May show ureteral wall thickening
- Less specific than CT
- Good for follow-up
MRI abdomen/pelvis:
- Alternative to CT (no radiation)
- Shows cystic lesions
- Good soft tissue detail

Ureteroscopy with biopsy (confirmatory):

Direct visualization of ureter
Biopsy of lesions to confirm benign nature
Rule out urothelial carcinoma
Therapeutic if obstructive

Laboratory:

Urinalysis:
- Hematuria (microscopic or gross)
- Pyuria (if infection present)
- Bacteriuria
Urine culture:
- If infection suspected
- Guide antibiotic therapy
Urine cytology:
- Rule out malignancy if concern
- Usually negative in ureteritis cystica
BMP/CMP:
- Renal function (creatinine, eGFR)
- Especially if obstruction present

Histopathology (if biopsy performed):

Multiple submucosal cysts
Cysts lined by transitional or cuboidal epithelium
Chronic inflammatory changes
No dysplasia or malignancy

Management

Treatment depends on symptoms and associated findings:

Observation (most common approach):

If asymptomatic and incidental finding
No obstruction or significant complications
Regular monitoring with imaging
Follow-up every 6-12 months initially
Patient education

Treatment of underlying cause:

Treat chronic UTIs:
- Antibiotics for active infection
- Prophylactic antibiotics if recurrent
- Address underlying risk factors
Remove/treat stones:
- Stone removal if causing chronic irritation
- Medical expulsive therapy
- Lithotripsy or ureteroscopy
Remove/change catheters:
- If long-term catheterization contributing
- Consider alternatives (intermittent catheterization)

Medical management:

Antibiotics: For associated UTIs
Pain management: NSAIDs or analgesics if symptomatic
Increased hydration: Prevent stone formation, flush urinary tract

Surgical intervention (rare):

Indications:
- Significant ureteral obstruction
- Recurrent infections despite medical management
- Uncertainty about malignancy
- Severe symptoms
Options:
- Ureteroscopic resection/ablation of cysts
- Ureteral stent placement (if obstruction)
- Partial ureterectomy (very rare, if extensive)
- Ureteroureterostomy (if segmental involvement)

Monitoring:

Periodic imaging (ultrasound or CT)
Urinalysis for hematuria and infection
Renal function monitoring
Watch for development of obstruction
Rule out progression (extremely rare to malignancy)

Prognosis:

Usually benign course
Good prognosis with monitoring
Rarely causes significant complications
Most patients remain asymptomatic
Very rare progression to malignancy (though extremely uncommon)
Can resolve spontaneously if underlying cause addressed

Complications

Potential complications (rare):

Urinary obstruction - cysts can rarely cause partial obstruction
Recurrent UTIs - chronic inflammation predisposes to infection
Hydronephrosis - if significant obstruction develops
Hematuria - microscopic or gross blood in urine
Ureteral stricture - chronic inflammation can lead to scarring
Extremely rare malignant transformation (case reports only)

When to seek professional help:

Persistent or severe flank pain
Noticeable blood in urine (gross hematuria)
Frequent or painful urination
Fever (suggests infection)
Decreased urine output

HCC Information

N28.86 does NOT map to a CMS-HCC - benign ureteral condition not risk-adjusted
No direct HCC weight or RAF score impact
Used for accurate diagnosis documentation and follow-up

Note: If ureteritis cystica leads to chronic kidney disease (N18.x) or other complications, those conditions may have HCC implications, but N28.86 itself does not.

RVU / wRVU Information

ICD-10-CM codes (including N28.86) do NOT carry RVUs or wRVUs
RVUs apply to CPT/HCPCS procedure codes only
N28.86 supports medical necessity for:
- Imaging studies (CT urography, ultrasound, MRI)
- Ureteroscopy
- Ureteral procedures
- Follow-up monitoring

Common CPT Procedure Pairings with N28.86

E/M Services:

99202-99205 - Office visit, new patient
99211-99215 - Office visit, established patient
99242-99245 - Office consultation

Imaging:

74150-74170 - CT abdomen (without/with contrast)
74176-74178 - CT abdomen and pelvis
74400-74410 - Urography (intravenous pyelogram)
74425 - Urography, antegrade
76770 - Ultrasound, retroperitoneal (includes kidney/ureter)
76775 - Ultrasound, retroperitoneal, limited
74181-74183 - MRI abdomen

Ureteroscopy and Procedures:

52000 - Cystourethroscopy (diagnostic)
52005 - Cystourethroscopy, with ureteral catheterization
52007 - Cystourethroscopy, with brush biopsy of ureter and/or renal pelvis
52204 - Cystourethroscopy, with biopsy
52320-52325 - Cystourethroscopy, with removal of calculus
52332 - Cystourethroscopy, with insertion of ureteral stent
52341-52346 - Cystourethroscopy with ureteroscopy
52352-52355 - Cystourethroscopy with ureteroscopy and biopsy

Ureteral Catheterization:

C1758 - Catheter, ureteral (HCPCS)
52005 - Cystourethroscopy with ureteral catheterization

Other Procedures (if complications/extensive disease):

50760 - Ureteroureterostomy
50782-50785 - Ureteroneocystostomy

Laboratory:

81001 - Urinalysis, automated with microscopy
87086 - Urine culture
88305 - Surgical pathology, biopsy (ureter)

Common Associated ICD-10-CM Codes

Often coded WITH N28.86:

Related ureter/kidney conditions:

N28.84 - Pyelitis cystica (if renal pelvis also involved, change to N28.85)
N28.85 - Pyeloureteritis cystica (if both pelvis and ureter)
N13.1 - Hydronephrosis with ureteral stricture (if obstruction)
N13.4 - Hydroureter (if dilation present)
N20.1 - Calculus of ureter (kidney stones)
N28.82 - Megaloureter (if dilated)

Associated infections:

N30.x - Cystitis (bladder infection)
N30.81/N30.91 - Other/unspecified cystitis with hematuria
N39.0 - Urinary tract infection, site not specified
N10 - Acute pyelonephritis (kidney infection)
N12 - Tubulo-interstitial nephritis

Associated symptoms:

R31.0 - Gross hematuria (if visible blood)
R31.21/R31.29 - Microscopic hematuria
R10.x - Abdominal pain (if symptomatic)
N23 - Unspecified renal colic (if pain present)

Risk factors/causes:

Z87.440 - Personal history of urinary tract infections
Z90.5 - Acquired absence of kidney (if contralateral kidney removed)

Clinical Examples: When to Use N28.86

✅ Example 1 - Incidental Finding on CT for Kidney Stones

SCENARIO:
55-year-old male with history of recurrent kidney stones presents
with right flank pain. CT urogram ordered.

CT Urogram Report:
- Small non-obstructing stone in right renal pelvis (4 mm)
- Incidental finding: Multiple small submucosal cystic lesions 
  in the right ureter consistent with ureteritis cystica
- No hydronephrosis
- Left kidney and ureter normal

Assessment:
- Right ureteral calculus, non-obstructing
- Ureteritis cystica, right ureter (incidental finding)

Plan:
- Medical expulsive therapy for stone
- Follow-up imaging in 3 months
- Monitor for obstruction or symptoms from ureteritis cystica
- Treat underlying cause (stone disease)

CODES:
- N20.1 (Calculus of ureter) - PRIMARY (symptomatic)
- N28.86 (Ureteritis cystica) - SECONDARY (incidental)

RATIONALE:
├─ Ureteritis cystica documented on CT
├─ Location: ureter ONLY (not renal pelvis)
├─ N28.86 appropriate for ureter-only involvement
├─ Stone is primary reason for encounter
└─ Ureteritis cystica is secondary/incidental finding

✅ Example 2 - Ureteroscopy with Biopsy Confirming Diagnosis

SCENARIO:
62-year-old female with recurrent UTIs and intermittent hematuria.
Imaging shows ureteral lesions concerning for possible tumor.
Ureteroscopy performed.

Ureteroscopy Findings:
- Multiple small cystic lesions in left distal ureter
- "Cobblestone" appearance of ureteral mucosa
- No solid masses visualized
- Biopsy performed

Pathology:
- Ureteritis cystica
- Multiple submucosal cysts lined by benign urothelium
- Chronic inflammatory changes
- No dysplasia or malignancy

Assessment:
- Ureteritis cystica, left ureter, confirmed by biopsy
- History of recurrent UTIs (likely causative)

Plan:
- Prophylactic antibiotics for recurrent UTI prevention
- Follow-up imaging in 6 months
- Monitor for hematuria

CODES:
- N28.86 (Ureteritis cystica) - PRIMARY
- Z87.440 (Personal history of urinary tract infections)
- R31.29 (Other microscopic hematuria) if still present

RATIONALE:
├─ Ureteritis cystica confirmed by pathology
├─ Location: left ureter only
├─ Benign process confirmed (not malignancy)
├─ N28.86 is correct code for ureter-only involvement
└─ History of UTIs likely contributory

✅ Example 3 - Bilateral Ureteritis Cystica

SCENARIO:
48-year-old male with history of long-term indwelling urinary catheter
(neurogenic bladder from spinal cord injury). Follow-up imaging.

Imaging:
- CT urogram: Bilateral small cystic lesions throughout both ureters
- No involvement of renal pelvis noted
- Mild bilateral hydroureter

Assessment:
- Ureteritis cystica, bilateral ureters
- Likely secondary to chronic catheterization
- Neurogenic bladder due to spinal cord injury

Plan:
- Consider changing to clean intermittent catheterization
- Monitor with serial imaging
- Urology follow-up

CODES:
- N28.86 (Ureteritis cystica) - can use even for bilateral
- N31.2 (Flaccid neuropathic bladder) - underlying condition
- G82.20 (Paraplegia, unspecified) - cause of neurogenic bladder
- N13.4 (Hydroureter) if significant dilation

RATIONALE:
├─ Ureteritis cystica involving BOTH ureters
├─ N28.86 appropriate (ureters only, not renal pelvis)
├─ Code underlying neurogenic bladder also
├─ Chronic catheterization is likely causative
└─ Bilateral still coded as N28.86 (no laterality in code)

❌ Example 4 - WRONG: Both Renal Pelvis and Ureter Involved

SCENARIO:
Patient with chronic pyelonephritis.

Imaging: Cystic lesions in BOTH renal pelvis and ureter

WRONG CODE: N28.86 (ureter only)
CORRECT CODE: N28.85 (Pyeloureteritis cystica)

WHY:
├─ N28.86 is for URETER ONLY
├─ When BOTH renal pelvis AND ureter involved → N28.85
├─ N28.85 = pyeloureteritis (pelvis + ureter)
├─ Different code required for combined involvement
└─ Documentation must specify all locations involved

KEY POINT: Check imaging - pelvis involved? → N28.85

❌ Example 5 - WRONG: Only Renal Pelvis Involved

SCENARIO:
CT shows cystic changes in renal pelvis only, ureter normal.

WRONG CODE: N28.86
CORRECT CODE: N28.84 (Pyelitis cystica)

WHY:
├─ N28.86 is for URETER involvement
├─ Renal pelvis ONLY = N28.84 (pyelitis cystica)
├─ Different anatomic location = different code
├─ Must match code to documented location
└─ Renal pelvis ≠ ureter

KEY POINT: Location determines code!
Pelvis only → N28.84
Ureter only → N28.86
Both → N28.85

❌ Example 6 - WRONG: Urothelial Carcinoma, Not Cystic Condition

SCENARIO:
Imaging suspicious for ureteritis cystica.
Ureteroscopy with biopsy performed.

Pathology: High-grade urothelial carcinoma

WRONG CODE: N28.86 (ureteritis cystica)
CORRECT CODE: C66.x (Malignant neoplasm of ureter, specify laterality)

WHY:
├─ Initial imaging suggested ureteritis cystica
├─ Biopsy revealed MALIGNANCY
├─ Malignancy takes precedence over benign diagnosis
├─ Must code based on final pathology
└─ Urothelial cancer ≠ ureteritis cystica

KEY POINT: Biopsy is gold standard!
Always code based on confirmed pathology.
Cancer can mimic benign cystic conditions.

Common Documentation Errors to AVOID

❌ Error 1: Not Specifying Location (Renal Pelvis vs Ureter)

WRONG: Documentation only says "cystic changes in collecting system"
├─ Need to specify: renal pelvis, ureter, or both
├─ Different codes for different locations
└─ CORRECT: Specify exact anatomic location

✅ CORRECT: "Ureteritis cystica in right ureter" OR
           "Pyeloureteritis cystica involving pelvis and ureter"

❌ Error 2: Using N28.86 for Combined Pelvis and Ureter Involvement

WRONG: Coding N28.86 when both renal pelvis and ureter have cysts
├─ N28.86 is for URETER ONLY
├─ Both locations = N28.85 (pyeloureteritis cystica)
└─ CORRECT: Use N28.85 when both involved

✅ CORRECT: Check imaging - both locations? → N28.85

❌ Error 3: Confusing with Hydroureter or Megaloureter

WRONG: Using N28.86 for simple ureteral dilation
├─ Ureteritis cystica = cystic lesions in wall
├─ Hydroureter (N13.4) = dilated ureter from obstruction
├─ Megaloureter (N28.82) = abnormally dilated ureter
└─ CORRECT: Different pathology, different codes

✅ CORRECT: Ureteritis cystica = cysts in wall, not simple dilation

❌ Error 4: Not Ruling Out Malignancy

WRONG: Coding N28.86 based on imaging alone without tissue diagnosis
├─ Imaging can be misleading
├─ Urothelial carcinoma can mimic ureteritis cystica
├─ Biopsy may be needed for definitive diagnosis
└─ CORRECT: Code based on confirmed diagnosis

✅ CORRECT: Consider biopsy if diagnostic uncertainty
Code based on pathology when available

❌ Error 5: Not Documenting Underlying Cause

WRONG: Coding only N28.86 without associated conditions
├─ Should document risk factors (UTIs, stones, catheter)
├─ Helps establish causation
└─ CORRECT: Document underlying/contributing factors

✅ CORRECT: N28.86 + underlying cause codes
(Z87.440 for history of UTIs, N20.x for stones, etc.)

Compliance Checklist

Before coding N28.86, verify:

Quick Reference Card

ICD-10-CM N28.86 - Ureteritis Cystica
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
USE WHEN:
• Ureteritis cystica documented (imaging or pathology)
• Multiple small cysts in URETER WALL only
• Benign cystic condition (not malignancy)
• Usually from chronic UTIs, stones, or catheterization
• Typically asymptomatic, incidental finding
 
DON'T USE WHEN:
• Only renal pelvis involved → N28.84 (Pyelitis cystica)
• Both pelvis AND ureter → N28.85 (Pyeloureteritis cystica)
• Hydroureter (simple dilation) → N13.4
• Ureteric stricture → N13.1 or N13.5
• Urothelial carcinoma → C66.x (malignancy)
 
CRITICAL LOCATION DISTINCTION:
• N28.84 = Renal pelvis ONLY (pyelitis cystica)
• N28.85 = Pelvis AND ureter (pyeloureteritis cystica)
• N28.86 = URETER ONLY (ureteritis cystica) ← YOU ARE HERE
• Documentation must specify location!
 
RARE CONDITION:
• Uncommon diagnosis
• Usually benign and asymptomatic
• Good prognosis with monitoring
• May need biopsy to rule out malignancy
 
IMAGING:
• CT urography - gold standard
• Shows "cobblestone" or "beaded" appearance
• Multiple small filling defects in ureter
• Submucosal cystic lesions
 
COMMON CAUSES:
• Chronic/recurrent UTIs (most common)
• Kidney stones (chronic irritation)
• Long-term catheterization
• Chronic ureteral obstruction
 
MANAGEMENT:
• Usually observation if asymptomatic
• Treat underlying cause (UTIs, stones)
• Monitor with serial imaging
• Surgery rarely needed
 
NOT HCC:
• No direct HCC mapping
• Benign condition
 
ICD-9 EQUIVALENT:
• 590.3 - Pyeloureteritis cystica (approximate)
 
BOTTOM LINE:
N28.86 = cystic lesions in URETER ONLY (not renal pelvis).
If pelvis also involved → use N28.85. Rare, benign condition
from chronic inflammation. Usually asymptomatic. Monitor.

Last Updated: February 9, 2026
For coding reference only - always verify against the current ICD-10-CM, official guidelines, payer policies, and facility rules.
Key concept: N28.86 is for ureteritis cystica - multiple small cysts in the ureter wall only. Critical distinction: N28.84 (renal pelvis only), N28.85 (both pelvis and ureter), N28.86 (ureter only). Location determines the correct code. This is a rare, typically benign condition from chronic inflammation (UTIs, stones, catheterization). Usually asymptomatic and found incidentally on imaging. May require biopsy to distinguish from urothelial carcinoma. Good prognosis with observation and treatment of underlying cause.

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N28.86