Is ICD-10-CM code Q22 billable?

No, Q22 (Congenital malformations of pulmonary and tricuspid valves) 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 Q22 belong to?

Q22 belongs to Chapter 17 of the ICD-10-CM tabular list: Q00–Q99 (Congenital Malformations, Deformations and Chromosomal Abnormalities).

Q22Not billable, use a more specific code below

Congenital malformations of pulmonary and tricuspid valves

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

9 billable codes under Q22: 6 are an MCC, 3 are a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.

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 Q22

Q22 can't be used on a claim. Pick a billable code below; grey headings group them.

Q22 MS-DRGs

As the principal diagnosis, all 9 billable codes under Q22 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 Q22

Notes on these codes point to Q22.

I08 Excludes2: multiple valve disease specified as nonrheumatic (I34.-, I35.-, I36.-, I37.-, I38.-, Q22.-, Q23.-, Q24.8-)

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.

Heart Valve Diseases

Heart valve disease happens when one or more of your heart valves don't work well. Your heart has four valves: the tricuspid, pulmonary, mitral, and aortic valves. The valves have flaps that open and close. The flaps make sure that blood flows in the right direction through your heart and to the rest of your body. When your heart beats, the flaps open to let blood through. Between heartbeats they close to stop the blood from flowing backwards.

Code history

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