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v1.0.0
ICD-10 Guide
ICD-10 CodesQ45.2

Q45.2

Billable

Congenital pancreatic cyst

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

Code Description

ICD-10 Q45.2 is a billable code used to indicate a diagnosis of congenital pancreatic cyst.

Key Diagnostic Point:

Congenital pancreatic cysts are fluid-filled sacs that develop in the pancreas during fetal development. These cysts can vary in size and may be solitary or multiple. They are often discovered incidentally during imaging studies for other conditions. While many congenital pancreatic cysts are asymptomatic, they can sometimes lead to complications such as abdominal pain, pancreatitis, or obstruction of the pancreatic duct. The exact etiology of these cysts is not fully understood, but they may be associated with genetic syndromes or other congenital anomalies. In pediatric patients, careful monitoring is essential to assess for any potential complications or changes in the cysts over time. Management may include surgical intervention if the cysts cause significant symptoms or complications. Understanding the implications of congenital pancreatic cysts is crucial for pediatricians and specialists in genetics, as they may be part of broader syndromic presentations that require comprehensive evaluation and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and symptoms of pancreatic cysts.
  • Potential association with other congenital anomalies.
  • Need for imaging studies to confirm diagnosis.
  • Differentiation from acquired cysts or other pancreatic conditions.

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings.
  • Failure to note associated congenital anomalies.
  • Misclassification of cyst type (congenital vs. acquired).
  • Lack of follow-up documentation regarding cyst management.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed clinical notes including symptoms, imaging results, and management plans.

Common Clinical Scenarios

Pediatric patients presenting with abdominal pain or incidental findings on imaging.

Billing Considerations

Consideration of the child's growth and development in relation to the cyst.

Genetics

Documentation Requirements

Family history documentation and genetic testing results if applicable.

Common Clinical Scenarios

Patients with congenital pancreatic cysts as part of a genetic syndrome requiring counseling.

Billing Considerations

Assessment for syndromic associations and implications for family members.

Coding Guidelines

Inclusion Criteria

Use Q45.2 When
  • Follow the official ICD
  • CM guidelines for coding congenital conditions, ensuring accurate documentation of the diagnosis and any associated anomalies
  • Use additional codes as necessary to capture the full clinical picture

Exclusion Criteria

Do NOT use Q45.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

49320CPT Code

Laparoscopic exploration of the pancreas

Clinical Scenario

Used when surgical intervention is required for symptomatic cysts.

Documentation Requirements

Operative report detailing findings and interventions.

Specialty Considerations

Pediatric surgical notes should emphasize congenital aspects.

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 pancreatic cysts, 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 pancreatic cysts, 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 pancreatic cysts, 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 symptoms of congenital pancreatic cysts?

Common symptoms may include abdominal pain, nausea, vomiting, or signs of pancreatitis. However, many cysts are asymptomatic and found incidentally during imaging.