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ICD-10 Guide
ICD-10 CodesChapter 17: Congenital malformations and chromosomal abnormalitiesQ61

Q61

Non-billable

Cystic kidney disease

Chapter 17:Congenital malformations and chromosomal abnormalities

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 Q61 is a used to indicate a diagnosis of cystic kidney disease.

Key Diagnostic Point:

Cystic kidney disease (Q61) encompasses a range of hereditary and acquired conditions characterized by the presence of fluid-filled cysts in the kidneys. This category includes conditions such as autosomal dominant polycystic kidney disease (ADPKD), autosomal recessive polycystic kidney disease (ARPKD), and medullary cystic kidney disease. These conditions can lead to significant renal impairment and other systemic complications, making early diagnosis and management crucial for patient outcomes. The clinical significance of Q61 lies in its association with chronic kidney disease (CKD) and end-stage renal disease (ESRD), necessitating careful monitoring and treatment strategies to mitigate progression and manage symptoms effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of conditions covered
  • Potential for comorbidities
  • Need for multidisciplinary management

Audit Risk Factors

  • Inaccurate coding of specific cystic conditions
  • Lack of comprehensive documentation
  • Misunderstanding of hereditary versus acquired forms

Specialty Focus

Medical Specialties

Nephrology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Genetics

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical and administrative impact of the Q61 code category is significant, as it plays a vital role in tracking the prevalence of cystic kidney diseases and their outcomes in the population. Accurate coding can influence quality measures and healthcare trends, particularly in the management of chronic kidney disease and its complications. Furthermore, understanding the implications of these conditions can guide public health initiatives aimed at improving kidney health and reducing the burden of renal disease in the community.

ICD-9 vs ICD-10

The clinical and administrative impact of the Q61 code category is significant, as it plays a vital role in tracking the prevalence of cystic kidney diseases and their outcomes in the population. Accurate coding can influence quality measures and healthcare trends, particularly in the management of chronic kidney disease and its complications. Furthermore, understanding the implications of these conditions can guide public health initiatives aimed at improving kidney health and reducing the burden of renal disease in the community.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the complexity of the condition and the treatment provided. It is essential to ensure that all documentation supports the diagnosis and any procedures performed, as this will directly impact reimbursement rates. Additionally, coding for related services, such as imaging and laboratory tests, should be aligned with the primary diagnosis to avoid claim denials.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for Q61

Coding & Billing References

  • •
    Official ICD-10 Guidelines for Q61

Frequently Asked Questions

What conditions are included in Q61?

Q61 includes autosomal dominant polycystic kidney disease (ADPKD), autosomal recessive polycystic kidney disease (ARPKD), and medullary cystic kidney disease, among others.

When should I use Q61 codes?

Q61 codes should be used when diagnosing patients with cystic kidney diseases, particularly when these conditions are confirmed through imaging or genetic testing.

What documentation is required for Q61?

Documentation should include clinical findings, imaging results, family history, and any genetic testing results that confirm the diagnosis of cystic kidney disease.