Other congenital malformations of intestine
In Other congenital malformations of the digestive system (Q38-Q45), chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities
10 billable codes under Q43: 9 are a CC; 3 map to HCC 78 (Intestinal Obstruction/Perforation).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.
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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 Q43
Q43 can't be used on a claim. Pick a billable code below; grey headings group them.
- Q43.0Meckel's diverticulum (displaced) (hypertrophic)
- Q43.1Hirschsprung's disease
- Q43.2Other congenital functional disorders of colon
- Q43.3Congenital malformations of intestinal fixation
- Q43.4Duplication of intestine
- Q43.5Ectopic anus
- Q43.6Congenital fistula of rectum and anus
- Q43.7Persistent cloaca
- Q43.8Other specified congenital malformations of intestine
- Q43.9Congenital malformation of intestine, unspecified
Q43 MS-DRGs
As the principal diagnosis, the billable codes under Q43 group to MS-DRG 393, 394, 395, 380, 381, or 382 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 393 Other Digestive System Diagnoses with MCC (9 of 10 codes)
- DRG 394 Other Digestive System Diagnoses with CC (9 of 10 codes)
- DRG 395 Other Digestive System Diagnoses without CC/MCC (9 of 10 codes)
- DRG 380 Complicated Peptic Ulcer with MCC (1 of 10 codes)
- DRG 381 Complicated Peptic Ulcer with CC (1 of 10 codes)
- DRG 382 Complicated Peptic Ulcer without CC/MCC (1 of 10 codes)
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Birth Defects
A birth defect is a problem that happens while a baby is developing in the mother's body. Most birth defects happen during the first 3 months of pregnancy. One out of every 33 babies in the United States is born with a birth defect.
Read more about birth defects on MedlinePlusColonic Diseases
Your colon, also known as the large intestine, is part of your digestive system. It's a long, hollow tube at the end of your digestive tract where your body makes and stores stool. Many disorders affect the colon's ability to work properly. Some of these include:
Read more about colonic diseases on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.