ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
DiagnosesAdult Polycystic Kidney Disease

Adult Polycystic Kidney Disease

ICD-10 Coding for Adult Polycystic Kidney Disease(Q61.2, N18.6)

PRIMARY SPECIALTYNephrology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Adult Polycystic Kidney Disease?
Essential facts and insights about Adult Polycystic Kidney Disease

Key Clinical Considerations:

  • Presence of multiple cysts in the kidneys, often detected via imaging studies such as ultrasound or CT scan.
  • Elevated blood pressure and renal function tests indicating possible renal impairment.
  • Family history of polycystic kidney disease, as it is often inherited in an autosomal dominant pattern.
  • Physical examination may reveal abdominal or flank pain, palpable kidney masses, or signs of hypertension.
  • Severity criteria include the degree of renal function impairment, classified as stages of chronic kidney disease (CKD).

Clinical Information

Clinical Criteria & Documentation Requirements

  • Complete medical history including family history of kidney disease and symptoms experienced by the patient.
  • Use of specific terminology such as 'autosomal dominant polycystic kidney disease' or 'ADPKD' when documenting.
  • Examples include documenting imaging results that confirm cyst presence and renal function tests indicating CKD.
  • Medical necessity documentation should include justification for imaging studies and laboratory tests performed.
  • Quality measures may include tracking blood pressure readings and renal function over time.

Coding Guidelines

Usage Guidelines & Examples

  • Use Q61.2 for patients diagnosed with adult polycystic kidney disease confirmed by imaging and clinical findings.
  • Do not use this code for patients with simple renal cysts or other types of kidney disease without cystic changes.
  • Related codes include Q61.1 for childhood polycystic kidney disease, which has different clinical implications.
  • Common coding errors include misclassifying simple cysts as polycystic kidney disease; ensure imaging confirms multiple cysts.
  • In complex cases, consider additional codes for associated conditions like hypertension or chronic kidney disease.

Code Exclusions

Important Exclusions

  • Excludes conditions such as simple renal cysts (N28.1) and other non-cystic renal diseases.
  • Alternative codes for excluded conditions include N28.9 for unspecified disorders of the kidney.
  • Conditions are excluded to ensure accurate representation of the disease process and appropriate treatment planning.
  • Common exclusion mistakes include failing to differentiate between simple cysts and polycystic kidney disease; ensure imaging confirms diagnosis.
  • Related but distinct conditions include nephronophthisis and medullary sponge kidney, which have different coding.

Related ICD-10 Codes

Primary Codes
Q61.2
Adult Polycystic Kidney Disease
N18.6
End Stage Renal Disease
Ancillary Codes
N18.x
Differential Codes
Q61.3
Q61.3
for polycystic kidney conditions not specified as adult type.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Nephrology

Specialty Applications

  • Applies to patients diagnosed with adult polycystic kidney disease, typically presenting in adulthood.
  • Patient populations include adults aged 30-50, with a family history of the disease being a significant risk factor.
  • Clinical settings include nephrology outpatient clinics, inpatient hospital settings, and emergency departments.
  • Specialty-specific applications are primarily in nephrology, but may also involve urology and genetics.
  • Treatment contexts include management of hypertension, renal function monitoring, and preparation for renal replacement therapy.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Template 1

Template: 'Patient diagnosed with adult polycystic kidney disease based on imaging findings of multiple renal cysts.'

Template 2

Template: 'Clinical presentation consistent with ADPKD including hypertension and abdominal pain.'

Template 3

Template: 'Diagnostic criteria met as evidenced by ultrasound showing multiple cysts in both kidneys.'

Template 4

Template: 'Treatment plan initiated for ADPKD with management of hypertension and regular monitoring of renal function.'

Template 5

Template: 'Follow-up care for adult polycystic kidney disease including monitoring of blood pressure and renal function tests.'

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What documentation is required for this diagnosis?

Documentation should include imaging results, family history, and clinical symptoms.

How does this differ from similar diagnoses?

ADPKD is characterized by multiple cysts and specific inheritance patterns, unlike simple cysts.

What are common billing considerations?

Ensure that all diagnostic tests and treatments are medically necessary and well-documented.

What procedures are typically associated?

Common procedures include renal ultrasound, CT scans, and possibly renal biopsy.

Are there any quality reporting implications?

Quality measures may include tracking renal function and blood pressure management in patients.