ICD-10 Coding for Polycystic Kidney Disease(Q61.2, Q61.3)
Complete ICD-10-CM coding and documentation guide for Polycystic Kidney Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Polycystic Kidney Disease
Q61.0-Q61.9Primary Range
Congenital malformations of the kidney
This range includes all types of polycystic kidney disease, both autosomal dominant and recessive.
Chronic kidney disease (CKD) stages
Used to specify the stage of CKD when associated with PKD.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Q61.2 | Polycystic kidney, adult type | Use for adult patients with confirmed ADPKD. |
|
| Q61.3 | Polycystic kidney, infantile type | Use for infant patients with confirmed ARPKD. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for polycystic kidney disease
Essential facts and insights about Polycystic Kidney Disease
Primary ICD-10-CM Codes for polycystic kidney disease
Decision Criteria
clinical Criteria
- Presence of multiple renal cysts and family history of ADPKD.
documentation Criteria
- Documented CKD stage if renal impairment is present.
Applicable To
- Autosomal Dominant Polycystic Kidney Disease (ADPKD)
Excludes
- Autosomal Recessive Polycystic Kidney Disease (Q61.3)
Clinical Validation Requirements
- Family history of ADPKD
- Ultrasound showing ≥3 unilateral cysts (age <40) or ≥2 bilateral cysts (age >40)
Code-Specific Risks
- Misclassification with ARPKD in adults
Coding Notes
- Ensure documentation specifies ADPKD and any associated CKD stage.
Q61.3 - Polycystic kidney, infantile type
Use for infant patients with confirmed ARPKD.
Applicable To
- Autosomal Recessive Polycystic Kidney Disease (ARPKD)
Excludes
- Autosomal Dominant Polycystic Kidney Disease (Q61.2)
Clinical Validation Requirements
- Onset in infancy
- Hepatic fibrosis on imaging
Coding Notes
Ensure documentation specifies ARPKD and any associated hepatic fibrosis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Polycystic Kidney Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Q61.2.
Impact
Clinical: Inaccurate assessment of disease progression., Regulatory: Non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Ensure eGFR and CKD stage are documented in every visit.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records and statistics.
Mitigation Strategy
Ensure age and clinical presentation match ARPKD criteria.
Impact
Failure to document CKD stage can lead to audit issues.
Mitigation Strategy
Implement checklist for CKD documentation.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Polycystic Kidney Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Polycystic Kidney Disease
Use these documentation templates to ensure complete and accurate documentation for Polycystic Kidney Disease. These templates include all required elements for proper coding and billing.
Nephrology Consultation
Specialty: NephrologyRequired Elements
- Family history
- Imaging results
- CKD stage
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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