Is ICD-10-CM code Q20 billable?

No, Q20 (Congenital malformations of cardiac chambers and connections) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code Q20 belong to?

Q20 belongs to Chapter 17 of the ICD-10-CM tabular list: Q00–Q99 (Congenital Malformations, Deformations and Chromosomal Abnormalities).

Q20Not billable, use a more specific code below

Congenital malformations of cardiac chambers and connections

In Congenital malformations of the circulatory system (Q20-Q28), chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities

9 billable codes under Q20: 5 are an MCC, 1 is a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.

Instructional notes

Excludes1: not coded here, use a different code

dextrocardia with situs inversus (Q89.3)
mirror-image atrial arrangement with situs inversus (Q89.3)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Assign Q00-QA1 codes for documented congenital anomalies or genetic disorders at any age, coding non-inherent manifestations separately and sequencing Z38 first on the birth admission.

Read Section I.C.17 (page 74)

All codes under Q20

Q20 can't be used on a claim. Pick a billable code below; grey headings group them.

Q20 MS-DRGs

As the principal diagnosis, all 9 billable codes under Q20 group to MS-DRG 306 or 307 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

Other codes that refer to Q20

Notes on these codes point to Q20.

I27.21 Code Also: congenital heart disease (Q20-Q28)
P00.3 Includes: Newborn affected by maternal conditions classifiable to I00-I99, J00-J99, Q20-Q34 and not included in P00.0, P00.2
P29 Excludes2: congenital malformations of the circulatory system (Q20-Q28)
Z71.87 Code Also: congenital malformations of the circulatory system (Q20-Q28)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Congenital Heart Defects

Congenital heart defects (CHDs) are problems with the structure of the heart. "Congenital" means that that the problems are present at birth. These defects happen when a fetus's heart doesn't develop normally during pregnancy. Congenital heart defects are the most common type of birth defect.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.