Excludes1 pair
Q61.3 vs Q61.4
Q61.3 and Q61.4 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.
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
- Polycystic › degeneration, kidney
- Polycystic › kidney
- 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