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v1.0.0
ICD-10 Guide
ICD-10 CodesQ64.1

Q64.1

Billable

Exstrophy of urinary bladder

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

Code Description

ICD-10 Q64.1 is a billable code used to indicate a diagnosis of exstrophy of urinary bladder.

Key Diagnostic Point:

Exstrophy of the urinary bladder is a congenital malformation characterized by the abnormal development of the bladder, resulting in its exposure on the abdominal wall. This condition occurs due to a failure of the abdominal wall to close properly during fetal development, leading to the bladder being located outside the body. The severity of bladder exstrophy can vary, and it is often associated with other urinary tract anomalies, such as epispadias, renal agenesis, or posterior urethral valves. Children with bladder exstrophy may experience urinary incontinence, recurrent urinary tract infections, and complications related to the associated malformations. Surgical intervention is typically required to reconstruct the bladder and restore its normal position. Early diagnosis and management are crucial for improving outcomes and quality of life for affected individuals. The condition may also have implications for future fertility and psychosocial development, necessitating a multidisciplinary approach to care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in associated anomalies (e.g., epispadias, renal agenesis)
  • Need for detailed surgical documentation
  • Potential for multiple surgical interventions
  • Variations in clinical presentation and severity

Audit Risk Factors

  • Inadequate documentation of associated anomalies
  • Failure to capture all surgical interventions
  • Misclassification of severity or type of exstrophy
  • Lack of clarity in the clinical narrative

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation should include detailed descriptions of the child's growth, development, and any associated urinary tract anomalies.

Common Clinical Scenarios

Common scenarios include newborns diagnosed with bladder exstrophy during routine examinations or prenatal ultrasounds.

Billing Considerations

Consideration must be given to the child's age, developmental milestones, and the impact of surgical interventions on urinary function.

Genetics

Documentation Requirements

Genetic documentation should include family history, potential genetic syndromes associated with bladder exstrophy, and any chromosomal abnormalities.

Common Clinical Scenarios

Genetic counseling may be required for families with a history of congenital malformations or when associated syndromes are suspected.

Billing Considerations

Genetic testing may be indicated to rule out chromosomal abnormalities that could contribute to the condition.

Coding Guidelines

Inclusion Criteria

Use Q64.1 When
  • Follow official ICD
  • CM guidelines for coding congenital malformations, ensuring accurate documentation of associated conditions and surgical procedures

Exclusion Criteria

Do NOT use Q64.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

51840CPT Code

Bladder exstrophy repair

Clinical Scenario

Used during surgical intervention for bladder exstrophy.

Documentation Requirements

Detailed operative notes and pre-operative assessments.

Specialty Considerations

Pediatric urology specialists should provide comprehensive documentation.

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 ability to capture the complexity of bladder exstrophy and its associated anomalies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the ability to capture the complexity of bladder exstrophy and its associated anomalies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the ability to capture the complexity of bladder exstrophy and its associated anomalies.

Resources

Clinical References

  • •
    American Urological Association Guidelines

Coding & Billing References

  • •
    American Urological Association Guidelines

Frequently Asked Questions

What are the common associated conditions with bladder exstrophy?

Common associated conditions include epispadias, renal agenesis, and urinary tract infections. Accurate coding requires documentation of these associated anomalies.