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ICD-10 Guide
ICD-10 CodesQ63.8

Q63.8

Billable

Other specified congenital malformations of kidney

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

Code Description

ICD-10 Q63.8 is a billable code used to indicate a diagnosis of other specified congenital malformations of kidney.

Key Diagnostic Point:

Congenital malformations of the kidney encompass a variety of structural abnormalities that can significantly impact renal function and overall health. This code specifically refers to conditions that do not fall into the more commonly classified categories of renal agenesis, polycystic kidney disease, or other well-defined malformations. Renal agenesis, characterized by the absence of one or both kidneys, can lead to severe complications, including oligohydramnios and pulmonary hypoplasia. Polycystic kidney disease, a genetic disorder, results in the formation of numerous cysts in the kidneys, leading to renal failure over time. Bladder exstrophy is a rare condition where the bladder is exposed outside the body, often associated with other urinary tract anomalies. Posterior urethral valves, a condition where abnormal folds of tissue obstruct the urethra, can lead to hydronephrosis and renal damage. Accurate coding of these conditions is crucial for appropriate management and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of congenital malformations
  • Overlap with other congenital codes, leading to potential misclassification
  • Need for detailed clinical documentation to support coding
  • Potential for associated conditions requiring co-coding

Audit Risk Factors

  • Inadequate documentation of the specific congenital malformation
  • Failure to capture associated conditions or complications
  • Incorrect assignment of codes due to overlapping symptoms
  • Lack of clarity in the clinical narrative regarding the patient's condition

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation should include detailed birth history, prenatal imaging findings, and any surgical interventions performed.

Common Clinical Scenarios

Common scenarios include newborns presenting with renal agenesis or polycystic kidney disease, requiring immediate intervention and long-term follow-up.

Billing Considerations

Consideration must be given to the age of the patient and the developmental implications of the congenital malformation.

Genetics

Documentation Requirements

Genetic documentation should include family history, genetic testing results, and any syndromic associations with the congenital malformation.

Common Clinical Scenarios

Scenarios may involve genetic counseling for families with a history of congenital kidney malformations or syndromic presentations.

Billing Considerations

Genetic implications of congenital malformations should be documented to guide future family planning and management.

Coding Guidelines

Inclusion Criteria

Use Q63.8 When
  • According to ICD
  • 10 coding guidelines, congenital malformations should be coded based on the specific anatomical and functional abnormalities present
  • Documentation must support the diagnosis, including imaging studies and clinical evaluations

Exclusion Criteria

Do NOT use Q63.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

50360CPT Code

Nephrectomy, partial or complete

Clinical Scenario

Used in cases of renal agenesis or severe malformations requiring surgical intervention.

Documentation Requirements

Operative reports detailing the procedure and indication for surgery.

Specialty Considerations

Pediatric surgical documentation must include growth and developmental assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital malformations, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of congenital conditions and their management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital malformations, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of congenital conditions and their management.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better tracking of congenital conditions and their management.

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 Q63.8?

Documentation must include a clear diagnosis of the specific congenital malformation, any imaging studies performed, and details of associated conditions or complications. It is essential to provide a comprehensive clinical narrative to support the coding.