Have 2 patients that have Ureteropelvic junction obstructions, one is 13month old and the doctor stated "UPJ obstruction". On the 3 year old, doctor stated "UPJ obstruction, intermettiant". The doctor doesn't state that it's congenital on either patient, but the ICD 9 code goes to 753.21 which is congential. The hospital used 753.21 on the 13month old, but used 593.4 on the 3 yr old. Does anyone know if there are guidelines for using congenital codes? I thought the documentation had to state "congenital" before that code was used. I'm coding the case for the anesthesiologist on the case. Thanks for any help.