Q64.5 — Congenital absence of bladder and urethra
Q64.5 is a billable, specific ICD-10-CM code for congenital absence of bladder and urethra. It is valid for submission on a claim.
Risk adjustment
Q64.5 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
Q64.5 is named in 3 Medicare coverage policies — 3 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56802Billing and Coding: Urodynamics
- A57455Billing and Coding: Urodynamics
How Q64.5 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 Q64.5.
- Acystia
- Absence›urethra, congenital
- Agenesis›bladder
- Agenesis›urethra
- Absence›bladder›congenital
- Anomaly, anomalous›bladder›absence
- Anomaly, anomalous›urethra›absence
- Malformation›bladder›aplasia
- Malformation›urethra›aplasia
Related codes at this level
Codes that share Q64. If Q64.5 is not quite right, the correct code is usually one of these.
- Q64.0Epispadias
- Q64.1Exstrophy of urinary bladder
- Q64.2Congenital posterior urethral valves
- Q64.3Other atresia and stenosis of urethra and bladder neck
- Q64.4Malformation of urachus
- Q64.6Congenital diverticulum of bladder
- Q64.7Other and unspecified congenital malformations of bladder and urethra
- Q64.8Other specified congenital malformations of urinary system
- Q64.9Congenital malformation of urinary system, unspecified
Questions about Q64.5
- Is Q64.5 a billable ICD-10-CM code?
- Yes. Q64.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Q64.5 sit in the tabular list?
- Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Congenital malformations of the urinary system (Q60-Q64).