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ICD-10 Guide
ICD-10 CodesQ55.3

Q55.3

Billable

Atresia of vas deferens

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

Code Description

ICD-10 Q55.3 is a billable code used to indicate a diagnosis of atresia of vas deferens.

Key Diagnostic Point:

Atresia of the vas deferens is a congenital malformation characterized by the absence or obstruction of the vas deferens, the duct that transports sperm from the epididymis to the ejaculatory duct. This condition can lead to infertility in males, as sperm cannot be transported effectively. Atresia of the vas deferens is often associated with other congenital anomalies, particularly in syndromes such as cystic fibrosis, where it may occur alongside congenital bilateral absence of the vas deferens (CBAVD). Clinically, patients may present with normal external genitalia but may experience infertility or other reproductive issues later in life. Diagnosis typically involves imaging studies such as ultrasound or MRI, and genetic testing may be indicated to rule out associated syndromic conditions. Management may include surgical intervention or assisted reproductive technologies, depending on the severity of the atresia and the patient's reproductive goals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and associated conditions
  • Need for genetic testing and counseling
  • Potential for misdiagnosis with other congenital anomalies
  • Documentation of associated syndromic conditions

Audit Risk Factors

  • Inadequate documentation of associated congenital anomalies
  • Failure to document genetic counseling or testing
  • Misclassification of the condition as a non-congenital issue
  • Lack of clarity on the patient's reproductive health status

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed documentation of the patient's growth and development, any associated congenital anomalies, and referrals to specialists.

Common Clinical Scenarios

Pediatric patients presenting with infertility concerns, or those diagnosed with cystic fibrosis who may have associated vas deferens atresia.

Billing Considerations

Pediatric coders must be aware of the implications of the condition on future reproductive health and the importance of multidisciplinary care.

Genetics

Documentation Requirements

Documentation of family history, genetic testing results, and any syndromic associations.

Common Clinical Scenarios

Patients with a family history of congenital anomalies or those presenting with multiple congenital malformations.

Billing Considerations

Genetic coders should ensure accurate coding of syndromic conditions and understand the implications of genetic testing on management.

Coding Guidelines

Inclusion Criteria

Use Q55.3 When
  • Follow the official ICD
  • CM coding guidelines for congenital malformations, ensuring accurate documentation of the condition and any associated anomalies
  • Use additional codes as necessary to capture related conditions

Exclusion Criteria

Do NOT use Q55.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58661CPT Code

Laparoscopic vasectomy reversal

Clinical Scenario

Used in cases where atresia is diagnosed and surgical intervention is indicated.

Documentation Requirements

Documentation of the diagnosis, surgical indications, and patient consent.

Specialty Considerations

Urology specialists should ensure accurate coding of the procedure in relation to the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital conditions, including atresia of the vas deferens, which can improve data accuracy and patient care outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, including atresia of the vas deferens, which can improve data accuracy and patient care outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital conditions, including atresia of the vas deferens, which can improve data accuracy and patient care outcomes.

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 are the implications of atresia of the vas deferens on fertility?

Atresia of the vas deferens can lead to infertility in males, as sperm cannot be transported effectively. Management may include surgical intervention or assisted reproductive technologies, depending on the severity of the atresia and the patient's reproductive goals.