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ICD-10 Guide
ICD-10 CodesQ64.11

Q64.11

Billable

Supravesical fissure of urinary bladder

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

Code Description

ICD-10 Q64.11 is a billable code used to indicate a diagnosis of supravesical fissure of urinary bladder.

Key Diagnostic Point:

Supravesical fissure of the urinary bladder is a rare congenital malformation characterized by a vertical cleft or fissure in the bladder wall, typically located above the bladder neck. This condition can lead to significant urinary dysfunction, including incontinence and recurrent urinary tract infections. The fissure may be associated with other congenital anomalies of the urinary system, such as renal agenesis, bladder exstrophy, or posterior urethral valves. Diagnosis is often made through imaging studies, such as ultrasound or MRI, which can reveal the extent of the fissure and any associated abnormalities. Management may involve surgical intervention to repair the fissure and address any functional impairments. Early diagnosis and intervention are crucial to prevent complications and improve the quality of life for affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of the fissure
  • Potential association with other congenital anomalies
  • Need for detailed imaging studies for accurate diagnosis
  • Surgical intervention may vary based on individual anatomy

Audit Risk Factors

  • Inadequate documentation of associated congenital anomalies
  • Failure to specify the type and extent of the fissure
  • Misclassification of the condition due to similar-sounding codes
  • Lack of imaging reports to support the diagnosis

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation should include growth parameters, developmental milestones, and specific urinary symptoms. Detailed family history may also be relevant.

Common Clinical Scenarios

Common scenarios include infants presenting with urinary incontinence or recurrent UTIs, requiring evaluation for congenital anomalies.

Billing Considerations

Consideration of age-related anatomical differences and the impact of congenital conditions on growth and development is essential.

Genetics

Documentation Requirements

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

Common Clinical Scenarios

Scenarios may involve genetic counseling for families with a history of congenital urinary tract malformations.

Billing Considerations

Understanding the genetic basis of congenital conditions can aid in risk assessment and management strategies.

Coding Guidelines

Inclusion Criteria

Use Q64.11 When
  • According to the official coding guidelines, congenital conditions should be coded based on the specific anatomical and functional abnormalities present
  • Documentation must support the diagnosis and any associated conditions

Exclusion Criteria

Do NOT use Q64.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

50590CPT Code

Cystoscopy with urethral dilation

Clinical Scenario

Used in conjunction with diagnosis of supravesical fissure to assess urinary tract function.

Documentation Requirements

Documentation must include indications for the procedure and findings from the cystoscopy.

Specialty Considerations

Urology specialists should provide detailed reports on findings and interventions.

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 diagnoses and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of diagnoses and facilitating better patient management.

Reimbursement & Billing Impact

reimbursement.

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 Q64.11 accurately?

Accurate coding of Q64.11 is crucial for proper patient management, reimbursement, and tracking of congenital anomalies. It ensures that patients receive appropriate care and that healthcare providers are compensated for their services.