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v1.0.0
ICD-10 Guide
ICD-10 CodesQ55.29

Q55.29

Billable

Other congenital malformations of testis and scrotum

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 Q55.29 is a billable code used to indicate a diagnosis of other congenital malformations of testis and scrotum.

Key Diagnostic Point:

Congenital malformations of the testis and scrotum encompass a variety of conditions that can affect the development and function of male genital organs. This includes conditions such as hypospadias, where the urethral opening is located on the underside of the penis rather than at the tip, and cryptorchidism, where one or both testes fail to descend into the scrotum. Ambiguous genitalia, a condition where the external genitalia do not have a clear male or female appearance, can also fall under this category. Uterine malformations, while primarily affecting females, can be relevant in cases of intersex conditions or when assessing genetic syndromes that affect both sexes. These congenital anomalies can lead to complications such as infertility, increased risk of testicular cancer, and psychosocial issues related to gender identity. Accurate coding is essential for appropriate management and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of conditions
  • Need for detailed clinical documentation to support coding
  • Potential overlap with other congenital codes
  • Variations in treatment protocols based on specific malformations

Audit Risk Factors

  • Inadequate documentation of the specific malformation
  • Failure to specify laterality (e.g., unilateral vs. bilateral)
  • Misclassification of ambiguous genitalia
  • Inconsistent coding across interdisciplinary teams

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed history of the child's development, physical examination findings, and any surgical interventions performed.

Common Clinical Scenarios

Cases of newborns presenting with hypospadias or cryptorchidism requiring surgical correction.

Billing Considerations

Consideration of the child's age and developmental milestones when coding.

Genetics

Documentation Requirements

Genetic testing results, family history of congenital conditions, and any syndromic associations.

Common Clinical Scenarios

Evaluation of ambiguous genitalia in newborns and genetic counseling for families with a history of congenital anomalies.

Billing Considerations

Understanding the genetic basis of conditions and their implications for future pregnancies.

Coding Guidelines

Inclusion Criteria

Use Q55.29 When
  • Follow the official ICD
  • CM guidelines for coding congenital conditions, ensuring specificity in documentation and adherence to coding conventions for congenital malformations

Exclusion Criteria

Do NOT use Q55.29 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

54660CPT Code

Orchidopexy

Clinical Scenario

Used for surgical correction of cryptorchidism.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Urology-specific documentation may be required.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding congenital malformations, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding congenital malformations, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What documentation is required for coding Q55.29?

Documentation should include a detailed clinical description of the malformation, any surgical interventions performed, and follow-up care plans. Genetic testing results should also be included if applicable.