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ICD-10 Guide
ICD-10 CodesQ62.1

Q62.1

Billable

Congenital occlusion of ureter

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

Code Description

ICD-10 Q62.1 is a billable code used to indicate a diagnosis of congenital occlusion of ureter.

Key Diagnostic Point:

Congenital occlusion of the ureter is a rare but significant malformation of the urinary system, characterized by a blockage that prevents normal urine flow from the kidney to the bladder. This condition can lead to hydronephrosis, renal damage, and urinary tract infections if not diagnosed and treated promptly. The occlusion may occur due to various factors, including abnormal development of the ureter during fetal growth, which can be associated with other congenital anomalies such as renal agenesis, bladder exstrophy, or posterior urethral valves. In pediatric patients, early detection through imaging studies like ultrasound is crucial, as symptoms may not present until later in life. Management often involves surgical intervention to relieve the obstruction and restore normal urinary function. The prognosis depends on the severity of the obstruction and the presence of any associated anomalies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of the condition
  • Potential for associated congenital anomalies
  • Need for detailed imaging and surgical documentation
  • Differentiation from acquired urinary tract obstructions

Audit Risk Factors

  • Inadequate documentation of associated congenital anomalies
  • Failure to specify the severity of the obstruction
  • Lack of imaging studies to support diagnosis
  • Incorrect coding of related procedures

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation must include growth parameters, developmental milestones, and specific urinary symptoms.

Common Clinical Scenarios

Common scenarios include newborns presenting with abdominal distension or urinary tract infections.

Billing Considerations

Consideration must be given to the age of the patient and the timing of diagnosis, as symptoms may vary significantly.

Genetics

Documentation Requirements

Genetic documentation should include family history of congenital anomalies and any chromosomal studies performed.

Common Clinical Scenarios

Scenarios may involve genetic counseling for families with a history of urinary tract malformations.

Billing Considerations

Genetic factors may play a role in the occurrence of congenital urinary tract anomalies, necessitating thorough family history documentation.

Coding Guidelines

Inclusion Criteria

Use Q62.1 When
  • Follow official ICD
  • 10 guidelines for coding congenital conditions, ensuring accurate documentation of associated anomalies and clinical findings

Exclusion Criteria

Do NOT use Q62.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

50432CPT Code

Ureteral stent placement

Clinical Scenario

Used in cases of ureteral obstruction to facilitate urine flow.

Documentation Requirements

Document indication for stent placement and imaging findings.

Specialty Considerations

Urology specialists should provide detailed operative notes.

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, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 associated conditions with congenital occlusion of the ureter?

Common associated conditions include renal agenesis, bladder exstrophy, and posterior urethral valves, which may complicate the clinical picture and require multidisciplinary management.