ICD-10 Coding for Adult Polycystic Kidney Disease(Q61.2, N18.6)
Complete ICD-10-CM coding and documentation guide for Adult 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 Adult Polycystic Kidney Disease
Q61.0-Q61.9Primary Range
Congenital malformations of the kidney
This range includes codes for various forms of polycystic kidney disease, with Q61.2 specifically for adult polycystic kidney disease.
Chronic kidney disease (CKD) stages
These codes are used to specify the stage of CKD associated with ADPKD.
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 when diagnosing adult polycystic kidney disease confirmed by imaging or genetic testing. |
|
| N18.6 | End stage renal disease | Use when the patient has progressed to end stage renal disease. |
|
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 adult polycystic kidney disease
Essential facts and insights about Adult Polycystic Kidney Disease
Primary ICD-10-CM Codes for adult polycystic kidney disease
Decision Criteria
clinical Criteria
- Presence of ≥3 bilateral renal cysts (age ≤15) or ≥5 bilateral cysts (age ≥16) on imaging
documentation Criteria
- Document family history of ADPKD
Applicable To
- Autosomal dominant polycystic kidney disease
Excludes
- Other polycystic kidney (Q61.3)
Clinical Validation Requirements
- Imaging report with cyst count/volume
- Genetic test (PKD1/PKD2)
- Family history of ADPKD
Code-Specific Risks
- Confusion with Q61.3
- Omitting CKD stage when present
Coding Notes
- Ensure imaging or genetic testing confirms diagnosis.
N18.6 - End stage renal disease
Use when the patient has progressed to end stage renal disease.
Applicable To
- ESRD
Clinical Validation Requirements
- eGFR <15 mL/min/1.73m²
- Documentation of ESRD
Coding Notes
Ensure ESRD is documented in the patient's medical record.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Chronic kidney disease stages
N18.xDocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Adult 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
Always document eGFR and CKD stage.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Verify the type of polycystic kidney disease through imaging or genetic testing.
Impact
Lack of imaging documentation to support ADPKD diagnosis.
Mitigation Strategy
Ensure all imaging reports are included in patient records.
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 Adult Polycystic Kidney Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Adult Polycystic Kidney Disease
Use these documentation templates to ensure complete and accurate documentation for Adult Polycystic Kidney Disease. These templates include all required elements for proper coding and billing.
Nephrology Progress Note
Specialty: NephrologyRequired Elements
- Diagnosis confirmation
- Imaging results
- Genetic testing
- CKD staging
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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