1. ICD-10-CM Codes
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2. Q00-Q99 Congenital malformations, deformations and chromosomal abnormalities
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3. Q60-Q64 Congenital malformations of the urinary system
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4. Q61- Cystic kidney disease
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2020 ICD-10-CM Diagnosis Code Q61.3

Polycystic kidney, unspecified

2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt

• Q61.3 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
• The 2020 edition of ICD-10-CM Q61.3 became effective on October 1, 2019.
• This is the American ICD-10-CM version of Q61.3 - other international versions of ICD-10 Q61.3 may differ.

• Congenital cystic kidney disease
• Multiple congenital cysts of kidney
• Polycystic kidney disease

• A usually autosomal dominant and less frequently autosomal recessive genetic disorder characterized by the presence of numerous cysts in the kidneys leading to end-stage renal failure. The autosomal dominant trait is associated with abnormalities on the short arm of chromosome 16. Symptoms in patients with the autosomal dominant trait usually appear at middle age and include abdominal pain, hematuria, and high blood pressure. Patients may develop brain aneurysms and liver cysts. Patients with the autosomal recessive trait present with progressive renal failure early in life and symptoms resulting from hepatic fibrosis. The autosomal recessive trait is associated with abnormalities of chromosome 6. Polycystic kidney disease may also result as a side effect in patients on renal dialysis.
• Hereditary diseases that are characterized by the progressive expansion of a large number of tightly packed cysts within the kidney; there is an autosomal recessive form appearing in childhood and a later appearing autosomal dominant form; a similar acquired disease sometimes accompanies end-stage renal disease.
• Hereditary diseases that are characterized by the progressive expansion of a large number of tightly packed cysts within the kidneys. They include diseases with autosomal dominant and autosomal recessive inheritance.

• Q61.3 is considered exempt from POA reporting.

• 698 Other kidney and urinary tract diagnoses with mcc
• 699 Other kidney and urinary tract diagnoses with cc
• 700 Other kidney and urinary tract diagnoses without cc/mcc

Convert Q61.3 to ICD-9-CM

• 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
• 2017 (effective 10/1/2016): No change
• 2018 (effective 10/1/2017): No change
• 2019 (effective 10/1/2018): No change
• 2020 (effective 10/1/2019): No change

• Type 1 Excludes: Q61.4
  ICD-10-CM Diagnosis Code Q61.4

  Renal dysplasia

  2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt

  Applicable To

  • Multicystic dysplastic kidney
  • Multicystic kidney (development)
  • Multicystic kidney disease
  • Multicystic renal dysplasia

  Type 1 Excludes

  • polycystic kidney disease (Q61.11-Q61.3)

• Cyst (colloid) (mucous) (simple) (retention)
  • congenital NEC Q89.8
    ICD-10-CM Diagnosis Code Q89.8

    Other specified congenital malformations

    2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt

    Use Additional

    • code(s) to identify all associated manifestations
    • kidney Q61.00
      ICD-10-CM Diagnosis Code Q61.00

      Congenital renal cyst, unspecified

      2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt

      Applicable To

      • Cyst of kidney NOS (congenital)
      • more than one (multiple) Q61.02
        ICD-10-CM Diagnosis Code Q61.02

        Congenital multiple renal cysts

        2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
        • specified as polycystic Q61.3
  • kidney (acquired) N28.1
    ICD-10-CM Diagnosis Code N28.1

    Cyst of kidney, acquired

    2016 2017 2018 2019 2020 Billable/Specific Code

    Applicable To

    • Cyst (multiple) (solitary) of kidney (acquired)

    Type 1 Excludes

    • cystic kidney disease (congenital) (Q61.-)
    • more than one (multiple) Q61.02
      ICD-10-CM Diagnosis Code Q61.02

      Congenital multiple renal cysts

      2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
      • specified as polycystic Q61.3
• Degeneration, degenerative
  • kidney N28.89
    ICD-10-CM Diagnosis Code N28.89

    Other specified disorders of kidney and ureter

    2016 2017 2018 2019 2020 Billable/Specific Code
    • polycystic Q61.3
• Disease, diseased - see also Syndrome
  • kidney (functional) (pelvis) N28.9
    ICD-10-CM Diagnosis Code N28.9

    Disorder of kidney and ureter, unspecified

    2016 2017 2018 2019 2020 Billable/Specific Code

    Applicable To

    • Nephropathy NOS
    • Renal disease (acute) NOS
    • Renal insufficiency (acute)

    Type 1 Excludes

    • chronic renal insufficiency (N18.9)
    • unspecified nephritic syndrome (N05.-)
    • polycystic Q61.3
  • polycystic
    • kidney or renal Q61.3
  • renal (functional) (pelvis) N28.9
    - see also Disease, kidney
    ICD-10-CM Diagnosis Code N28.9

    Disorder of kidney and ureter, unspecified

    2016 2017 2018 2019 2020 Billable/Specific Code

    Applicable To

    • Nephropathy NOS
    • Renal disease (acute) NOS
    • Renal insufficiency (acute)

    Type 1 Excludes

    • chronic renal insufficiency (N18.9)
    • unspecified nephritic syndrome (N05.-)
    • polycystic (congenital) Q61.3
• Nephritis, nephritic (albuminuric) (azotemic) (congenital) (disseminated) (epithelial) (familial) (focal) (granulomatous) (hemorrhagic) (infantile) (nonsuppurative, excretory) (uremic) N05.9
  ICD-10-CM Diagnosis Code N05.9

  Unspecified nephritic syndrome with unspecified morphologic changes

  2016 2017 2018 2019 2020 Billable/Specific Code
  • polycystic Q61.3
• Polycystic (disease)
  • degeneration, kidney Q61.3
  • kidney Q61.3

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.