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ICD-10 Guide
ICD-10 CodesQ22.3

Q22.3

Billable

Other congenital malformations of pulmonary valve

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 Q22.3 is a billable code used to indicate a diagnosis of other congenital malformations of pulmonary valve.

Key Diagnostic Point:

Congenital malformations of the pulmonary valve can manifest in various forms, including pulmonary valve stenosis, atresia, or other structural anomalies that affect the normal flow of blood from the right ventricle to the pulmonary artery. These malformations can lead to significant hemodynamic changes, resulting in right ventricular hypertrophy, increased pressure in the right heart, and potential heart failure if not addressed. The severity of the condition often dictates the clinical management approach, which may include surgical intervention or catheter-based procedures. Accurate diagnosis typically involves echocardiography, which provides detailed imaging of the heart's structure and function. In some cases, additional imaging modalities such as MRI or CT scans may be utilized to assess the anatomy and associated anomalies. The presence of other congenital heart defects, such as septal defects or coarctation of the aorta, may complicate the clinical picture, necessitating a comprehensive evaluation and multidisciplinary management plan.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of pulmonary valve malformations
  • Potential for associated congenital heart defects
  • Need for precise documentation of anatomical details
  • Variability in treatment approaches and follow-up care

Audit Risk Factors

  • Inadequate documentation of associated congenital anomalies
  • Failure to specify the type of pulmonary valve malformation
  • Misclassification of severity or complexity of the condition
  • Inconsistent coding practices across different healthcare providers

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed pediatric history and physical examination findings, including growth and development assessments.

Common Clinical Scenarios

Infants presenting with cyanosis, failure to thrive, or heart murmurs; routine follow-up for known congenital heart defects.

Billing Considerations

Consideration of age-related anatomical changes and the impact of growth on congenital heart defects.

Genetics

Documentation Requirements

Family history of congenital heart defects, genetic testing results, and syndromic associations.

Common Clinical Scenarios

Genetic counseling for families with a history of congenital heart disease; evaluation of syndromic conditions such as DiGeorge syndrome.

Billing Considerations

Understanding the genetic basis of congenital heart defects and the implications for family planning.

Coding Guidelines

Inclusion Criteria

Use Q22.3 When
  • Follow the official ICD
  • CM coding guidelines for congenital conditions, ensuring accurate documentation of the specific type of malformation and any associated anomalies
  • Use additional codes as necessary to capture the full clinical picture

Exclusion Criteria

Do NOT use Q22.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

93306CPT Code

Echocardiography, transthoracic, real-time with interpretation

Clinical Scenario

Used for initial evaluation and follow-up of congenital heart defects.

Documentation Requirements

Echocardiographic findings must be documented clearly.

Specialty Considerations

Pediatric cardiology may require specific echocardiographic views.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital heart defects, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of congenital conditions and their outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital heart defects, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of congenital conditions and their outcomes.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better tracking of congenital conditions and their outcomes.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Coding for Congenital Heart Disease

Coding & Billing References

  • •
    American Academy of Pediatrics - Coding for Congenital Heart Disease

Frequently Asked Questions

What are the common associated conditions with Q22.3?

Common associated conditions include other congenital heart defects such as atrial septal defects, ventricular septal defects, and coarctation of the aorta. Accurate coding requires documentation of all associated anomalies.