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    v1.0.28
    OpenPayerBilling CodesOther disorders of kidney and ureterICD-10-CM n27-small-kidney-of-unknown-cause
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    ICD-10-CM Code For Small Kidney Of Unknown Cause: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group N27 includes diagnoses for small kidney or kidneys of unknown cause, covering unilateral and bilateral renal hypoplasia or atrophy when no specific etiology is documented. These ICD-10-CM diagnosis codes are used to document structural renal abnormalities, capturing laterality and the absence of an identified underlying cause relevant to renal function and clinical management. Accurate coding within the ICD-10-CM N27 group supports complete clinical documentation and appropriate reimbursement.

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    ICD-10-CM N27: Small Kidney Of Unknown Cause Overview

    The ICD-10-CM code group N27 represents small kidney of unknown cause, a set of diagnoses describing unilateral or bilateral small kidney(s) when a specific etiology is not identified. These codes target renal structural abnormality affecting the urinary system and renal function. Accurate coding matters for reimbursement because it documents the clinical condition that can influence severity assignment and medical necessity determinations.

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    When to Use

    Use a code from this group when medical record documentation notes a small kidney or kidneys and no definitive cause such as reflux, obstruction, or congenital malformation is identified. Select the code that reflects laterality if specified in the clinical documentation.

    ICD-10-CM Codes

    3 rows

    ICD-10-CM CodeDescription
    N27.0Small kidney, unilateral
    N27.1Small kidney, bilateral
    N27.9Small kidney, unspecified

    DRG Codes

    3 rows

    DRG CodeDescription
    698Other Kidney and Urinary Tract Diagnoses with MCC
    699Other Kidney and Urinary Tract Diagnoses with CC
    700Other Kidney and Urinary Tract Diagnoses without CC/MCC

    Typical Clinical Scenarios

    • A middle-aged adult presents to primary care for evaluation of chronic flank discomfort and routine laboratory testing reveals persistently reduced estimated glomerular filtration rate and imaging (renal ultrasound) shows one kidney noticeably smaller than the contralateral kidney with no clear prior insult documented; the presentation is an outpatient chronic kidney structural finding without identified etiology, so a code indicating small kidney of unspecified cause is assigned. Typical codes: N27.9.
    • An elderly patient is admitted from the emergency department after an episode of acute urinary tract obstruction due to ureteral stone; imaging performed during admission demonstrates that the affected kidney is atrophic and markedly smaller compared with prior studies, suggesting long-standing irreversible size loss as a complication of prior obstructive episodes, so a code for small kidney secondary to a known cause is used if laterality and cause are documented; when the small kidney is attributed to prior obstruction and laterality is specified as right or left, the appropriate code from the group is assigned. Typical codes: N27.1, N27.0.
    • A pediatric patient is evaluated in nephrology clinic for growth delay and recurrent urinary tract infections; renal ultrasound reveals unilateral renal hypoplasia/small kidney discovered during congenital anomaly workup with no acute symptoms, and the small kidney is noted as congenital or developmental in origin, prompting assignment of the congenital small kidney code when documented. Typical codes: N27.0.

    Related Codes

    N25-DISORDERS-RESULTING-FROM-IMPAIRED-RENAL-TUBULAR-FUNCTION

    ICD-10-CM Code For Disorders Resulting From Impaired Renal Tubular Function: Group Overview

    N26-UNSPECIFIED-CONTRACTED-KIDNEY

    ICD-10-CM Code For Unspecified Contracted Kidney: Group Overview

    N28-OTHER-DISORDERS-OF-KIDNEY-AND-URETER

    ICD-10-CM Code For Other Disorders Of Kidney And Ureter: Group Overview

    N29-OTHER-DISORDERS-OF-KIDNEY-AND-URETER

    ICD-10-CM Code For Other Disorders Of Kidney And Ureter In Diseases Classified Elsewhere: Group Overview

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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