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v1.0.0
ICD-10 Guide
ICD-10 CodesQ53.11

Q53.11

Billable

Abdominal testis, unilateral

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

Code Description

ICD-10 Q53.11 is a billable code used to indicate a diagnosis of abdominal testis, unilateral.

Key Diagnostic Point:

Abdominal testis, or unilateral cryptorchidism, is a congenital condition where one testis fails to descend into the scrotum and remains located in the abdominal cavity. This condition is often diagnosed during infancy or early childhood and can lead to complications such as infertility, testicular torsion, and increased risk of testicular cancer if left untreated. The descent of the testis typically occurs during the last trimester of pregnancy, and factors influencing this process can include hormonal imbalances, genetic predispositions, and environmental factors. Clinical evaluation often involves physical examination and imaging studies, such as ultrasound, to confirm the location of the testis. Treatment usually involves surgical intervention, known as orchidopexy, to relocate the testis into the scrotum, ideally performed before the child reaches one year of age to minimize long-term complications. Accurate coding of this condition is essential for proper management and follow-up care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and diagnosis timing
  • Need for precise documentation of testis location
  • Potential for associated conditions (e.g., hypospadias)
  • Differentiation from other forms of cryptorchidism

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to document associated congenital anomalies
  • Incorrect coding of surgical procedures performed
  • Lack of follow-up documentation post-surgery

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed physical examination notes, imaging results, and surgical reports.

Common Clinical Scenarios

Infants presenting with undescended testis during routine check-ups or referrals for surgical evaluation.

Billing Considerations

Consideration of associated conditions such as hypospadias or other genital anomalies that may require comprehensive management.

Genetics

Documentation Requirements

Family history of congenital conditions, genetic testing results if applicable.

Common Clinical Scenarios

Cases where cryptorchidism is part of a syndrome or associated with chromosomal abnormalities.

Billing Considerations

Assessment of genetic factors that may contribute to the condition, including syndromic associations.

Coding Guidelines

Inclusion Criteria

Use Q53.11 When
  • Follow the official ICD
  • CM guidelines for coding congenital malformations, ensuring accurate documentation of the condition's specifics and any associated anomalies

Exclusion Criteria

Do NOT use Q53.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

54640CPT Code

Orchidopexy

Clinical Scenario

Performed to correct unilateral abdominal testis.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Pediatric surgical documentation must include pre-operative and post-operative assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 allows for more specific coding of congenital conditions, improving the accuracy of diagnosis and treatment tracking for conditions like unilateral abdominal testis.

ICD-9 vs ICD-10

The transition to ICD-10 allows for more specific coding of congenital conditions, improving the accuracy of diagnosis and treatment tracking for conditions like unilateral abdominal testis.

Reimbursement & Billing Impact

The transition to ICD-10 allows for more specific coding of congenital conditions, improving the accuracy of diagnosis and treatment tracking for conditions like unilateral abdominal testis.

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 Q53.11 accurately?

Accurate coding of Q53.11 is crucial for ensuring appropriate treatment and follow-up care for children with unilateral abdominal testis. It helps in tracking outcomes and managing potential complications associated with cryptorchidism.