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ICD-10 Guide
ICD-10 CodesQ23.88

Q23.88

Billable

Other congenital malformations of aortic and mitral valves

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

Code Description

ICD-10 Q23.88 is a billable code used to indicate a diagnosis of other congenital malformations of aortic and mitral valves.

Key Diagnostic Point:

Congenital malformations of the aortic and mitral valves can manifest in various forms, including structural abnormalities that affect the normal function of these critical heart valves. These malformations may lead to significant hemodynamic changes and can be associated with other congenital heart defects such as septal defects, tetralogy of Fallot, and coarctation of the aorta. Patients may present with symptoms such as heart murmurs, cyanosis, or heart failure, depending on the severity of the malformation. Diagnosis typically involves echocardiography, which can visualize the structure and function of the heart valves. Management may include surgical intervention, such as valve repair or replacement, particularly in cases where the malformation leads to significant obstruction or regurgitation. The complexity of these conditions often necessitates a multidisciplinary approach, involving pediatric cardiologists, cardiothoracic surgeons, and geneticists, especially when associated with chromosomal abnormalities.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of malformations
  • Need for detailed anatomical descriptions in documentation
  • Potential for associated congenital heart defects
  • Interdisciplinary management requiring collaboration among specialists

Audit Risk Factors

  • Inadequate documentation of the specific type of valve malformation
  • Failure to document associated congenital heart defects
  • Lack of clarity on the severity of the condition
  • Inconsistent coding of follow-up procedures or interventions

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed clinical notes including symptoms, diagnostic imaging results, and treatment plans are essential for accurate coding.

Common Clinical Scenarios

Pediatric patients presenting with heart murmurs, failure to thrive, or cyanosis due to congenital heart defects.

Billing Considerations

Consideration of growth and development impacts on treatment decisions and coding.

Genetics

Documentation Requirements

Genetic testing results, family history of congenital conditions, and any syndromic associations must be documented.

Common Clinical Scenarios

Patients with congenital heart defects undergoing genetic counseling for syndromic conditions.

Billing Considerations

Awareness of chromosomal abnormalities that may co-occur with congenital heart defects, influencing management and coding.

Coding Guidelines

Inclusion Criteria

Use Q23.88 When
  • Follow the official ICD
  • CM guidelines for coding congenital conditions, ensuring specificity in documentation and adherence to coding conventions for congenital malformations

Exclusion Criteria

Do NOT use Q23.88 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

33405CPT Code

Aortic valve replacement

Clinical Scenario

Used in cases of severe aortic valve malformation requiring surgical intervention.

Documentation Requirements

Operative reports detailing the procedure and indications for surgery.

Specialty Considerations

Pediatric cardiothoracic surgery documentation must be precise to support the procedure.

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 for congenital conditions.

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 for congenital conditions.

Reimbursement & Billing Impact

reimbursement processes for congenital conditions.

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 congenital malformations associated with Q23.88?

Common congenital malformations associated with Q23.88 include various forms of aortic and mitral valve anomalies, which may coexist with other congenital heart defects such as septal defects and coarctation of the aorta. Accurate coding requires detailed documentation of each specific malformation.