N35.12
BillablePostinfective urethral stricture, not elsewhere classified, female
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is N35.12 an HCC code?
No. N35.12 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
N35.12 is the ICD-10-CM diagnosis code for postinfective urethral stricture, not elsewhere classified, female. A narrowing of the urethra (the tube that carries urine) in females that developed after a previous infection. N35.12 sits in the ICD-10-CM chapter for diseases of the genitourinary system (n00-n99), within the section covering other diseases of the urinary system (n30-n39).
N35.12 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Verify documentation confirms the stricture is post-infectious and not due to trauma or other causes.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for N35.12 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation confirms the stricture is post-infectious and not due to trauma or other causes
- •This code is female-specific; ensure patient gender is documented correctly