ICD-10 Guide

Acquired Absence Of Kidney

ICD-10 Coding for Acquired Absence of Kidney(Z90.5)

PRIMARY SPECIALTYNephrology

COMPLEXITYHigh

LAST UPDATED09/15/2025

Sam Tuffun, PT, DPT

Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Acquired Absence Of Kidney?

Acquired absence of kidney (ICD-10 code Z90.5) refers to the condition where one or both kidneys are absent due to surgical removal, trauma, or other pathological processes. Key clinical points include: 1) It may result from nephrectomy due to cancer or severe kidney disease. 2) Patients may present with compensatory hypertrophy of the remaining kidney. 3) Regular monitoring of renal function is essential to prevent complications. Typical use cases for this diagnosis code include patients with a history of kidney removal or congenital absence diagnosed later in life. The etiology can be surgical, traumatic, or due to vascular compromise. Pathophysiologically, the absence of a kidney can lead to changes in renal function and fluid balance. Clinically, patients may be asymptomatic or present with symptoms related to the remaining kidney's function, such as hypertension or electrolyte imbalances.

Key Clinical Considerations:

Diagnosis requires a confirmed history of nephrectomy or congenital absence, supported by surgical reports or imaging studies.
Signs may include hypertension, changes in urination patterns, or abdominal pain; symptoms may vary based on the remaining kidney's health.
Resolution criteria are not applicable as this condition is permanent; however, monitoring of renal function is essential.
Imaging studies (ultrasound, CT scan) can confirm the absence of the kidney and assess the condition of the remaining kidney.

Clinical Information

Clinical Criteria & Documentation Requirements

Documentation must include the reason for kidney absence (e.g., nephrectomy, trauma) and any relevant clinical history.
Compliant documentation includes clear statements of the diagnosis, surgical history, and current renal function status; non-compliant documentation may lack specificity.
Template phrases: 'Patient has a history of nephrectomy due to [reason]' or 'Current renal function is stable post-nephrectomy.'
Medical necessity documentation should justify the need for ongoing monitoring and management of renal function.

Coding Guidelines

Usage Guidelines & Examples

Use this code when documenting a patient with a history of nephrectomy or congenital absence; for example, a patient post-kidney removal due to cancer.
Do NOT use this code for patients with bilateral renal agenesis or acute kidney injury; these conditions have different coding.
Correct usage: 'Patient with acquired absence of left kidney post-nephrectomy'; incorrect: 'Patient with kidney disease'.
Common errors include using this code for acute conditions; ensure the absence is confirmed and permanent.

Code Exclusions

Important Exclusions

Excluded conditions include congenital absence of kidney (Q60) and acute kidney injury (N17) due to different etiologies.
Alternative codes for exclusions may include N18 for chronic kidney disease.
Common exclusion errors involve misclassifying congenital conditions as acquired; ensure accurate patient history.
Certain conditions are excluded to maintain specificity in coding and avoid misrepresentation of the patient's status.

Specialty Focus

Primary Specialty

Nephrology

Specialty Applications

This diagnosis applies to patients post-nephrectomy or with congenital absence diagnosed later in life.
Appropriate in clinical scenarios involving renal function monitoring or management of complications.
Applicable in various practice settings, including outpatient nephrology clinics and inpatient surgical recovery.
Specialty-specific considerations include nephrology for ongoing management and urology for surgical history.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

Comprehensive clinical documentation
Accurate code selection based on clinical criteria
Proper exclusion considerations
Specialty-specific coding guidelines

Documentation

Documentation Templates

Template 1

Template: 'Acquired absence of kidney diagnosed based on surgical history and imaging findings.'

Template 2

Template: 'Patient presents with hypertension consistent with acquired absence of left kidney.'

Template 3

Template: 'Diagnostic criteria met: nephrectomy performed on [date], current renal function stable.'

Template 4

Template: 'Treatment plan includes monitoring renal function for acquired absence of kidney.'

Billing Information

Billing Considerations

Ensure proper documentation for billing
Verify code specificity requirements
Check for any additional codes needed
Review payer-specific guidelines

Common Issues

Insufficient clinical documentation
Incorrect code selection
Missing supporting diagnoses
Timing and frequency documentation

Frequently Asked Questions

What documentation is required for this code?

Documentation must include surgical history, reason for nephrectomy, and current renal function.

When should this code be used vs similar codes?

Use this code for acquired absence; use Q60 for congenital absence.

What are common billing issues with this code?

Issues may arise from lack of documentation supporting the absence; ensure clarity.

What procedures are commonly associated?

Related CPT codes may include nephrectomy codes and renal function tests.

What is Acquired Absence Of Kidney?

Key Clinical Considerations:

Diagnosis requires a confirmed history of nephrectomy or congenital absence, supported by surgical reports or imaging studies.
Signs may include hypertension, changes in urination patterns, or abdominal pain; symptoms may vary based on the remaining kidney's health.
Resolution criteria are not applicable as this condition is permanent; however, monitoring of renal function is essential.
Imaging studies (ultrasound, CT scan) can confirm the absence of the kidney and assess the condition of the remaining kidney.

Acquired Absence Of Kidney

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Template 1

Template 2

Template 3

Template 4

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

What documentation is required for this code?

When should this code be used vs similar codes?

What are common billing issues with this code?

What procedures are commonly associated?

Acquired Absence Of Kidney

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Template 1

Template 2

Template 3

Template 4

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

What documentation is required for this code?

When should this code be used vs similar codes?

What are common billing issues with this code?

What procedures are commonly associated?