2024 ICD-10-CM Diagnosis Code Q64.4

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

• Abdominal wall fistula
• Abdominal wall fistula
• Allantoic cyst
• Allantoic cyst
• Congenital fistula of urachus
• Fistula of urachus
• Infected urachal cyst
• Infection of urachal remnant
• Infection of urachal sinus
• Malformation of urachus
• Malformation of urachus
• Malformation of urachus
• Patent urachus
• Umbilical fistula
• Umbilical fistula
• Urachal diverticulum
• Urachal sinus
• Urachal sinus

Clinical Information

• Allantoic Cyst

  an umbilical cyst that arises from allantoic tissue that did not regress during gestational development. most cases involve a patent urachus that allows for communication to the urinary bladder.

• Urachal Diverticulum

  a condition in which the urachus fails to close proximal to the bladder, resulting in a non-detrusor, blind-ending pouch at the dome of the bladder.

• Patent Urachus

  a congenital abnormality that results from the failure of the lumen of urachus to be obliterated. it presents with leakage of urine from the bladder through the umbilicus.

Q64.4 is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Present on Admission (POA)

Q64.4 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.

CMS POA Indicator Options and Definitions

Convert Q64.4 to ICD-9-CM

• ICD-9-CM Code: 753.7 - Anomalies of urachus

Patient Education

Urethral Disorders

The urethra is the tube that allows urine to pass out of the body. In men, it's a long tube that runs through the penis. It also carries semen in men. In women, it's short and is just above the vagina. Urethral problems may happen due to aging, illness, or injury. They include:

• Urethral cancer - a rare cancer that happens more often in men
• Urethral stricture - a narrowing of the opening of the urethra
• Urethritis - inflammation of the urethra, sometimes caused by infection

Urethral problems may cause pain or difficulty passing urine. You may also have bleeding or discharge from the urethra.

Doctors diagnose urethral problems using different tests. These include urine tests, x-rays and an examination of the urethra with a scope called a cystoscope. Treatment depends on the cause of the problem. It may include medicines and, in severe cases, surgery.

Code History

• FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.