Congenital malformations of great veins
In Congenital malformations of the circulatory system (Q20-Q28), chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities
9 billable codes under Q26: 7 are a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.
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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 Q26
Q26 can't be used on a claim. Pick a billable code below; grey headings group them.
- Q26.0Congenital stenosis of vena cava
- Q26.1Persistent left superior vena cava
- Q26.2Total anomalous pulmonary venous connection
- Q26.3Partial anomalous pulmonary venous connection
- Q26.4Anomalous pulmonary venous connection, unspecified
- Q26.5Anomalous portal venous connection
- Q26.6Portal vein-hepatic artery fistula
- Q26.8Other congenital malformations of great veins
- Q26.9Congenital malformation of great vein, unspecified
Q26 MS-DRGs
As the principal diagnosis, the billable codes under Q26 group to MS-DRG 306, 307, 299, 300, or 301 (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 (7 of 9 codes)
- DRG 307 Cardiac Congenital and Valvular Disorders without MCC (7 of 9 codes)
- DRG 299 Peripheral Vascular Disorders with MCC (2 of 9 codes)
- DRG 300 Peripheral Vascular Disorders with CC (2 of 9 codes)
- DRG 301 Peripheral Vascular Disorders without CC/MCC (2 of 9 codes)
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.