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ICD-10 Guide
ICD-10 CodesQ61.9

Q61.9

Billable

Cystic kidney disease, unspecified

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

Code Description

ICD-10 Q61.9 is a billable code used to indicate a diagnosis of cystic kidney disease, unspecified.

Key Diagnostic Point:

Cystic kidney disease encompasses a range of congenital malformations characterized by the presence of cysts in the kidneys. These cysts can vary in size and number, leading to renal dysfunction. The condition may arise from genetic mutations or developmental anomalies during fetal growth. In pediatric patients, cystic kidney disease can manifest as renal agenesis, where one or both kidneys fail to develop, or as polycystic kidney disease, which is characterized by the formation of numerous cysts that can impair kidney function. Other related congenital anomalies include bladder exstrophy, where the bladder is exposed outside the body, and posterior urethral valves, which can obstruct urinary flow and lead to hydronephrosis. Accurate diagnosis and coding are essential for appropriate management and treatment, as these conditions can lead to significant morbidity if not addressed early.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of cystic kidney diseases
  • Overlap with other congenital urinary tract anomalies
  • Need for detailed imaging and genetic testing results
  • Potential for associated syndromic conditions

Audit Risk Factors

  • Inadequate documentation of the specific type of cystic kidney disease
  • Failure to document associated congenital anomalies
  • Lack of genetic testing results in the medical record
  • Misclassification of cystic kidney disease as acquired rather than congenital

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation should include growth parameters, developmental milestones, and specific symptoms related to renal function.

Common Clinical Scenarios

Common scenarios include newborns presenting with abdominal masses, hypertension, or urinary tract infections due to congenital anomalies.

Billing Considerations

Considerations include the need for multidisciplinary care involving nephrology, urology, and genetics.

Genetics

Documentation Requirements

Genetic documentation should include family history, results of genetic testing, and any syndromic associations.

Common Clinical Scenarios

Genetic counseling scenarios may involve families with a history of cystic kidney disease or related syndromes.

Billing Considerations

Considerations include the implications of genetic findings for family planning and the potential for other affected family members.

Coding Guidelines

Inclusion Criteria

Use Q61.9 When
  • Follow official coding guidelines for congenital conditions, ensuring that all relevant clinical information is documented
  • Use additional codes to specify associated conditions or complications

Exclusion Criteria

Do NOT use Q61.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76700CPT Code

Ultrasound, abdomen, complete

Clinical Scenario

Used to evaluate renal structure in suspected cystic kidney disease.

Documentation Requirements

Document indications for ultrasound and findings.

Specialty Considerations

Pediatric specialists should ensure age-appropriate imaging protocols.

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, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, 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 is the significance of coding cystic kidney disease accurately?

Accurate coding of cystic kidney disease is crucial for appropriate management, treatment planning, and ensuring that patients receive the necessary follow-up care. It also impacts reimbursement and data collection for congenital conditions.