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ICD-10 Guide
ICD-10 CodesQ27.1

Q27.1

Billable

Congenital renal artery stenosis

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

Code Description

ICD-10 Q27.1 is a billable code used to indicate a diagnosis of congenital renal artery stenosis.

Key Diagnostic Point:

Congenital renal artery stenosis is a condition characterized by the narrowing of one or both renal arteries, which can lead to reduced blood flow to the kidneys. This malformation can result in hypertension, renal ischemia, and potential renal failure if not diagnosed and managed appropriately. The condition is often associated with other congenital anomalies, particularly those affecting the cardiovascular system. In pediatric patients, renal artery stenosis may present with symptoms such as abdominal pain, hypertension, or failure to thrive. Diagnosis typically involves imaging studies such as Doppler ultrasound, CT angiography, or MRI to assess blood flow and anatomical structure. Treatment options may include medical management of hypertension, angioplasty, or surgical intervention to restore normal blood flow. Early detection and intervention are crucial to prevent long-term complications associated with this condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of the condition.
  • Need for comprehensive imaging studies for accurate diagnosis.
  • Potential association with other congenital heart defects.
  • Documentation of hypertension and renal function tests.

Audit Risk Factors

  • Inadequate documentation of associated congenital anomalies.
  • Failure to document imaging studies performed.
  • Misclassification of the severity of stenosis.
  • Lack of follow-up documentation for hypertension management.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation should include growth parameters, blood pressure readings, and any associated symptoms or findings from physical examinations.

Common Clinical Scenarios

Common scenarios include a pediatric patient presenting with hypertension or renal dysfunction, requiring evaluation for renal artery stenosis.

Billing Considerations

Consideration must be given to the patient's age, growth patterns, and any family history of renal or cardiovascular conditions.

Genetics

Documentation Requirements

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

Common Clinical Scenarios

Scenarios may involve genetic counseling for families with a history of congenital renal anomalies or syndromes associated with renal artery stenosis.

Billing Considerations

Genetic factors may play a role in the presentation of renal artery stenosis, necessitating thorough documentation of any genetic evaluations.

Coding Guidelines

Inclusion Criteria

Use Q27.1 When
  • Official coding guidelines for congenital conditions emphasize the need for accurate documentation of the diagnosis, associated conditions, and any interventions performed
  • Coders should ensure that all relevant clinical information is captured to support the diagnosis and treatment provided

Exclusion Criteria

Do NOT use Q27.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76700CPT Code

Ultrasound, abdomen, complete

Clinical Scenario

Used to evaluate renal artery stenosis in pediatric patients.

Documentation Requirements

Documentation must include indications for the ultrasound and findings related to renal artery anatomy.

Specialty Considerations

Pediatric specialists should ensure that the ultrasound is interpreted in the context of the patient's overall health and any 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 renal artery stenosis, enhancing the ability to capture the complexity and associated conditions accurately.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, including renal artery stenosis, enhancing the ability to capture the complexity and associated conditions accurately.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital conditions, including renal artery stenosis, enhancing the ability to capture the complexity and associated conditions accurately.

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 symptoms of congenital renal artery stenosis?

Common symptoms include hypertension, abdominal pain, and signs of renal dysfunction such as failure to thrive in infants. Early diagnosis is crucial for effective management.