Is Q61.3 a billable ICD-10-CM code?

Yes. Q61.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Q61.3 sit in the tabular list?

Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Congenital malformations of the urinary system (Q60-Q64).

What cannot be coded together with Q61.3?

Q61.3 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Q61.3 (Q61) and apply to it just the same.

Q61.3

Q61.3 — Polycystic kidney, unspecified

Billable / specific codeICD-10-CMPOA exemptunspecified

Q61.3 is a billable, specific ICD-10-CM code for polycystic kidney, unspecified. It is valid for submission on a claim.

Excludes1 inherited from the categories above Q61.3

These are not written on Q61.3, but they bind it: a note on a category applies to every code beneath it. Billing Q61.3 with anything listed here is a denial.

Written on Q61 — Cystic kidney disease

acquired cyst of kidney (N28.1)
Potter's syndrome (Q60.6)

Other codes that can never be billed with Q61.3

These codes carry an Excludes1 note pointing at Q61.3. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Q61.3 alone.

N28.1Cyst of kidney, acquired
Q61.4Renal dysplasia

Risk adjustment

Q61.3 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

Q61.3 is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A55336Billing and Coding: Retroperitoneal Ultrasound
A56421Billing and Coding: CT of the Abdomen and Pelvis
A56805Billing and Coding: Magnetic Resonance Angiography (MRA)
A57643Billing and Coding: Lab: Cystatin C Measurement

How Q61.3 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to Q61.3.

Nephritis, nephritic›polycystic
Polycystic›degeneration, kidney
Polycystic›kidney
Degeneration, degenerative›kidney›polycystic
Disease, diseased›kidney›polycystic
Disease, diseased›polycystic›kidney or renal
Disease, diseased›renal›polycystic(congenital)
Cyst›kidney›more than one›specified as polycystic
Cyst›congenital NEC›kidney›more than one›specified as polycystic

Code history

Q61.3 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share Q61. If Q61.3 is not quite right, the correct code is usually one of these.

Questions about Q61.3

Is Q61.3 a billable ICD-10-CM code?: Yes. Q61.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Q61.3 sit in the tabular list?: Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Congenital malformations of the urinary system (Q60-Q64).
What cannot be coded together with Q61.3?: Q61.3 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Q61.3 (Q61) and apply to it just the same.