ICD-10 Coding for Autosomal Dominant Polycystic Kidney Disease(Q61.2, Q61.3)
Complete ICD-10-CM coding and documentation guide for Autosomal Dominant 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 Autosomal Dominant Polycystic Kidney Disease
Q61.2-Q61.3Primary Range
Polycystic kidney disease codes
These codes cover the spectrum of polycystic kidney diseases, with Q61.2 specifically for 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 | Autosomal dominant polycystic kidney disease | Use when ADPKD is confirmed through genetic testing or meets clinical criteria. |
|
| Q61.3 | Polycystic kidney, unspecified | Use when documentation lacks confirmation of inheritance pattern. |
|
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 autosomal dominant polycystic kidney disease
Essential facts and insights about Autosomal Dominant Polycystic Kidney Disease
Primary ICD-10-CM Codes for autosomal dominant polycystic kidney disease
Decision Criteria
clinical Criteria
- Presence of ≥3 bilateral renal cysts and family history
coding Criteria
- Confirmed genetic testing for PKD1 or PKD2
Applicable To
- Confirmed ADPKD with genetic testing
- ≥3 bilateral renal cysts with family history
Excludes
- Autosomal recessive polycystic kidney disease (Q61.19)
Clinical Validation Requirements
- Genetic testing showing PKD1 or PKD2 mutations
- Imaging showing multiple bilateral renal cysts
- Family history of ADPKD
Code-Specific Risks
- Misclassification with ARPKD
- Undercoding due to lack of genetic confirmation
Coding Notes
- Ensure documentation supports the use of Q61.2 with genetic or imaging evidence.
Q61.3 - Polycystic kidney, unspecified
Use when documentation lacks confirmation of inheritance pattern.
Applicable To
- Polycystic kidney disease without specified inheritance pattern
Excludes
- Specific types of polycystic kidney disease (Q61.2, Q61.19)
Clinical Validation Requirements
- Imaging showing renal cysts without family history or genetic confirmation
Coding Notes
Avoid using Q61.3 when specific diagnosis can be confirmed.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other specified disorders of kidney
N28.89Differential 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 Autosomal Dominant 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: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Always document family history for suspected genetic conditions., Use templates to ensure comprehensive documentation.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Misclassification affects compliance with coding standards., Data Quality: Impacts accuracy of patient records and data analytics.
Mitigation Strategy
Verify inheritance pattern and age of onset to differentiate.
Impact
Reimbursement: May affect DRG assignment and reimbursement rates., Compliance: Leads to potential audit issues., Data Quality: Reduces specificity and accuracy of health data.
Mitigation Strategy
Ensure documentation supports specific coding with genetic or imaging evidence.
Impact
Lack of documentation for genetic testing results can lead to audit issues.
Mitigation Strategy
Ensure all genetic testing results 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 Autosomal Dominant Polycystic Kidney Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Autosomal Dominant Polycystic Kidney Disease
Use these documentation templates to ensure complete and accurate documentation for Autosomal Dominant Polycystic Kidney Disease. These templates include all required elements for proper coding and billing.
Initial ADPKD Diagnosis
Specialty: NephrologyRequired Elements
- Family history
- Imaging results
- Genetic testing
- Blood pressure readings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Autosomal Dominant Polycystic Kidney Disease? Ask your questions below.