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ICD-10 Guide
ICD-10 CodesQ64.6

Q64.6

Billable

Congenital diverticulum of bladder

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

Code Description

ICD-10 Q64.6 is a billable code used to indicate a diagnosis of congenital diverticulum of bladder.

Key Diagnostic Point:

Congenital diverticulum of the bladder is a rare malformation characterized by the presence of an outpouching or sac-like structure in the bladder wall, which is present at birth. This condition can lead to various complications, including urinary tract infections, bladder dysfunction, and potential renal impairment due to obstructive uropathy. The diverticulum may arise from a weakness in the bladder wall or as a result of abnormal embryological development during the formation of the urinary system. It is essential to differentiate this condition from acquired diverticula, which can occur due to chronic bladder outlet obstruction or other acquired factors. Diagnosis is typically made through imaging studies such as ultrasound or voiding cystourethrogram, and management may involve surgical intervention depending on the severity of symptoms and associated complications. Congenital diverticulum of the bladder can occur in isolation or as part of syndromic presentations involving other congenital anomalies of the urinary tract, such as renal agenesis or bladder exstrophy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and associated anomalies
  • Need for imaging studies for accurate diagnosis
  • Potential for surgical intervention and follow-up care
  • Differentiation from acquired conditions

Audit Risk Factors

  • Inadequate documentation of associated congenital anomalies
  • Failure to specify the type of diverticulum
  • Misclassification with acquired conditions
  • Lack of imaging reports in the medical record

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed pediatric history, including prenatal and perinatal factors, growth and development milestones, and any associated congenital anomalies.

Common Clinical Scenarios

Pediatric patients presenting with recurrent urinary tract infections, bladder dysfunction, or during evaluation for other congenital urinary tract anomalies.

Billing Considerations

Consideration of age-related factors in diagnosis and management, as well as the potential for long-term follow-up in pediatric patients.

Genetics

Documentation Requirements

Genetic evaluation reports, family history of congenital anomalies, and any chromosomal studies performed.

Common Clinical Scenarios

Patients with congenital diverticulum of the bladder being assessed for syndromic associations or chromosomal abnormalities.

Billing Considerations

Awareness of genetic syndromes that may include urinary tract anomalies, necessitating comprehensive genetic counseling.

Coding Guidelines

Inclusion Criteria

Use Q64.6 When
  • Follow official ICD
  • CM guidelines for coding 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 Q64.6 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

50590CPT Code

Cystoscopy, diagnostic

Clinical Scenario

Used to evaluate bladder function and anatomy in patients with congenital diverticulum.

Documentation Requirements

Document indication for cystoscopy and findings related to the diverticulum.

Specialty Considerations

Pediatric urologists may require specific documentation related to congenital anomalies.

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 congenital diverticulum of the bladder, which enhances the ability to capture the complexity of these cases and improve patient care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, including congenital diverticulum of the bladder, which enhances the ability to capture the complexity of these cases and improve patient care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital conditions, including congenital diverticulum of the bladder, which enhances the ability to capture the complexity of these cases and improve patient care.

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 common complications associated with congenital diverticulum of the bladder?

Common complications include urinary tract infections, bladder dysfunction, and potential renal impairment due to obstructive uropathy. Early diagnosis and management are crucial to prevent these complications.