Q61.3 vs Q61.4
Q61.3 and Q61.4 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 Q61.4
polycystic kidney disease (Q61.11-Q61.3)
Q61.3
Polycystic kidney, unspecified
BillableUnspecified
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q60-Q64
Indexed under
- Nephritis, nephritic › polycystic (albuminuric) (azotemic) (congenital) (disseminated) (epithelial) (familial) (focal) (granulomatous) (hemorrhagic) (infantile) (nonsuppurative, excretory) (uremic)
- Polycystic › degeneration, kidney (disease)
- Polycystic › kidney (disease)
- Degeneration, degenerative › kidney › polycystic
- Disease, diseased › kidney › polycystic
Q61.4
Renal dysplasia
Billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q60-Q64
Use when the record says
- Multicystic dysplastic kidney
- Multicystic kidney (development)
- Multicystic kidney disease
- Multicystic renal dysplasia
Indexed under
- Multicystic kidney (development)
- Dysplasia › kidney
- Dysplasia › renal
- Disease, diseased › kidney › multicystic
- Dysplasia › kidney › multicystic
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