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ICD-10 Guide
ICD-10 CodesQ62.11

Q62.11

Billable

Congenital occlusion of ureteropelvic junction

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

Code Description

ICD-10 Q62.11 is a billable code used to indicate a diagnosis of congenital occlusion of ureteropelvic junction.

Key Diagnostic Point:

Congenital occlusion of the ureteropelvic junction (UPJ) is a condition characterized by a blockage at the junction where the ureter meets the renal pelvis. This malformation can lead to hydronephrosis, which is the swelling of a kidney due to a build-up of urine. In pediatric patients, UPJ obstruction is one of the most common causes of renal obstruction and can present with symptoms such as abdominal pain, urinary tract infections, or failure to thrive. Diagnosis is typically made through imaging studies such as ultrasound or CT scans, which reveal the degree of obstruction and any associated renal anomalies. Treatment often involves surgical intervention to relieve the obstruction and restore normal urinary flow. The condition may be associated with other congenital malformations of the urinary system, including renal agenesis, polycystic kidney disease, bladder exstrophy, and posterior urethral valves, necessitating comprehensive evaluation and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various types of urinary tract malformations
  • Understanding associated congenital anomalies
  • Interpreting imaging studies for accurate diagnosis
  • Navigating surgical coding for corrective procedures

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to link diagnosis with appropriate surgical procedures
  • Misclassification of associated congenital anomalies
  • Inconsistent coding across different healthcare settings

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed history of urinary symptoms, growth parameters, and imaging results.

Common Clinical Scenarios

Pediatric patients presenting with abdominal pain or urinary tract infections.

Billing Considerations

Consideration of growth and development milestones in the context of renal function.

Genetics

Documentation Requirements

Family history of congenital anomalies, genetic testing results, and counseling notes.

Common Clinical Scenarios

Patients with multiple congenital anomalies requiring genetic evaluation.

Billing Considerations

Understanding the genetic syndromes associated with urinary tract malformations.

Coding Guidelines

Inclusion Criteria

Use Q62.11 When
  • Follow the official ICD
  • CM guidelines for coding congenital malformations, ensuring accurate documentation of the condition's severity and any associated anomalies

Exclusion Criteria

Do NOT use Q62.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

50436CPT Code

Ureteropelvic junction obstruction repair

Clinical Scenario

Used in surgical correction of UPJ obstruction in pediatric patients.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Pediatric urology specialists should provide detailed surgical 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 symptoms of congenital occlusion of the ureteropelvic junction?

Common symptoms include abdominal pain, urinary tract infections, and failure to thrive in infants. Diagnosis is often made through imaging studies.