ICD-10 Coding for Renal Cystic Disease(Q61.0, Q61.2, N28.1)
Complete ICD-10-CM coding and documentation guide for Renal Cystic Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Renal Cystic Disease
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Q61.0 | Congenital solitary renal cyst | Use when imaging shows a solitary cyst with no family history of polycystic kidney disease. |
|
| Q61.2 | Adult polycystic kidney disease, autosomal dominant | Use when there is a family history of ADPKD and imaging confirms multiple bilateral cysts. |
|
| N28.1 | Acquired cyst of kidney | Use for cysts developed in the context of ESRD or after prolonged dialysis. |
|
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 renal cystic disease
Essential facts and insights about Renal Cystic Disease
Primary ICD-10-CM Codes for renal cystic disease
Decision Criteria
clinical Criteria
- Solitary cyst with normal renal function
Applicable To
- Congenital simple renal cyst
Excludes
- Acquired renal cyst (N28.1)
Clinical Validation Requirements
- Ultrasound shows solitary cyst
- Negative family history
- Normal renal function
Code-Specific Risks
- Assuming congenital without proper documentation
Coding Notes
- Ensure documentation specifies congenital nature.
Q61.2 - Adult polycystic kidney disease, autosomal dominant
Use when there is a family history of ADPKD and imaging confirms multiple bilateral cysts.
Applicable To
- ADPKD
Excludes
- Acquired renal cyst (N28.1)
Clinical Validation Requirements
- CT reveals >10 bilateral cysts
- Family history of ADPKD
- Elevated creatinine
Coding Notes
Document family history and imaging findings.
N28.1 - Acquired cyst of kidney
Use for cysts developed in the context of ESRD or after prolonged dialysis.
Applicable To
- Acquired renal cyst
Excludes
- Congenital renal cyst (Q61.x)
Clinical Validation Requirements
- Patient on dialysis >3 months
- New cyst development post-ESRD
Coding Notes
Ensure documentation specifies acquired nature.
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 Renal Cystic Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Q61.0.
Impact
Clinical: Incomplete clinical picture, Regulatory: Non-compliance with coding guidelines, Financial: Loss of potential reimbursement
Mitigation Strategy
Review patient history for CKD, Ensure linkage in documentation
Impact
Reimbursement: Incorrect DRG assignment, Compliance: Potential audit issues, Data Quality: Inaccurate patient records
Mitigation Strategy
Verify documentation for congenital vs. acquired nature
Impact
Failure to document whether cysts are congenital or acquired.
Mitigation Strategy
Implement provider queries for unclear 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 Renal Cystic Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Renal Cystic Disease
Use these documentation templates to ensure complete and accurate documentation for Renal Cystic Disease. These templates include all required elements for proper coding and billing.
ADPKD with CKD
Specialty: NephrologyRequired Elements
- Family history
- Imaging findings
- CKD stage
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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