Congenital malformations of cardiac septa
In Congenital malformations of the circulatory system (Q20-Q28), chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities
17 billable codes under Q21: 1 is an MCC, 13 are a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.
Advertisements
Instructional notes
Excludes1: not coded here, use a different code
- acquired cardiac septal defect (I51.0)
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.
All codes under Q21
Q21 can't be used on a claim. Pick a billable code below; grey headings group them.
- Q21.0Ventricular septal defect
- Q21.1Atrial septal defect
- Q21.10Atrial septal defect, unspecified
- Q21.11Secundum atrial septal defect
- Q21.12Patent foramen ovale
- Q21.13Coronary sinus atrial septal defect
- Q21.14Superior sinus venosus atrial septal defect
- Q21.15Inferior sinus venosus atrial septal defect
- Q21.16Sinus venosus atrial septal defect, unspecified
- Q21.19Other specified atrial septal defect
- Q21.2Atrioventricular septal defect
- Q21.20Atrioventricular septal defect, unspecified as to partial or complete
- Q21.21Partial atrioventricular septal defect
- Q21.22Transitional atrioventricular septal defect
- Q21.23Complete atrioventricular septal defect
- Q21.3Tetralogy of Fallot
- Q21.4Aortopulmonary septal defect
- Q21.8Other congenital malformations of cardiac septa
- Q21.9Congenital malformation of cardiac septum, unspecified
Q21 MS-DRGs
As the principal diagnosis, the billable codes under Q21 group to MS-DRG 306, 307, 791, or 793 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 306 Cardiac Congenital and Valvular Disorders with MCC (17 of 17 codes)
- DRG 307 Cardiac Congenital and Valvular Disorders without MCC (17 of 17 codes)
- DRG 791 Prematurity with Major Problems (1 of 17 codes)
- DRG 793 Full Term Neonate with Major Problems (1 of 17 codes)
Other codes that refer to Q21
Notes on these codes point to Q21.
- Q87.85 Code Also: congenital malformations of cardiac septa (Q21.-)
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.
Read more about congenital heart defects on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.