N28.1 vs Q61
N28.1 and Q61 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on N28.1
cystic kidney disease (congenital) (Q61.-)
N28.1
Cyst of kidney, acquired
Billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N25-N29
Use when the record says
- Cyst (multiple) (solitary) of kidney (acquired)
Indexed under
- Cyst › kidney (colloid) (mucous) (simple) (retention)
- Cyst › paranephric (colloid) (mucous) (simple) (retention)
- Cyst › peripelvic (colloid) (mucous) (simple) (retention)
- Solitary › cyst, kidney
- Cyst › kidney › acquired (colloid) (mucous) (simple) (retention)
Q61
Cystic kidney disease
Not billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q60-Q64
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027