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ICD-10 Guide
ICD-10 CodesQ23.9

Q23.9

Billable

Congenital malformation of aortic and mitral valves, unspecified

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

Code Description

ICD-10 Q23.9 is a billable code used to indicate a diagnosis of congenital malformation of aortic and mitral valves, unspecified.

Key Diagnostic Point:

Congenital malformations of the aortic and mitral valves can lead to significant hemodynamic disturbances and clinical manifestations in affected individuals. These malformations may include structural abnormalities such as stenosis, regurgitation, or atresia of the valves, which can result in compromised cardiac function. The aortic valve regulates blood flow from the heart to the aorta, while the mitral valve controls blood flow between the left atrium and left ventricle. When these valves are malformed, it can lead to conditions such as left ventricular hypertrophy, heart failure, or arrhythmias. Diagnosis typically involves echocardiography, which provides detailed imaging of the heart's structure and function. Management may require medical therapy, surgical intervention, or catheter-based procedures depending on the severity of the malformation. Early detection and intervention are crucial for improving outcomes in pediatric patients with these congenital heart defects.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of valve malformations
  • Need for detailed imaging studies for accurate diagnosis
  • Potential for associated congenital heart defects complicating coding
  • Documentation requirements for surgical interventions and follow-ups

Audit Risk Factors

  • Inadequate documentation of the specific type of valve malformation
  • Failure to capture associated congenital heart defects
  • Misclassification of congenital versus acquired conditions
  • Lack of clarity in the treatment plan and follow-up care

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation must include growth parameters, developmental milestones, and specific symptoms related to cardiac function.

Common Clinical Scenarios

Common scenarios include a newborn presenting with cyanosis, failure to thrive, or a murmur detected during routine examination.

Billing Considerations

Consideration of age-specific norms for echocardiographic findings and the impact of congenital heart defects on overall health.

Genetics

Documentation Requirements

Genetic documentation should include family history of congenital heart defects and any chromosomal abnormalities identified through testing.

Common Clinical Scenarios

Scenarios may involve genetic counseling for families with a history of congenital heart disease or syndromic presentations.

Billing Considerations

Understanding the genetic syndromes associated with congenital heart defects, such as Down syndrome or Turner syndrome, is crucial for accurate coding.

Coding Guidelines

Inclusion Criteria

Use Q23.9 When
  • Follow official ICD
  • CM guidelines for coding congenital malformations, ensuring specificity in documentation and adherence to coding conventions
  • Codes should reflect the most accurate diagnosis based on clinical findings and imaging results

Exclusion Criteria

Do NOT use Q23.9 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 report detailing the procedure and indication for surgery.

Specialty Considerations

Pediatric cardiology may require additional pre-operative assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding congenital malformations, improving data accuracy and facilitating better patient management. Q23.9 provides a clear framework for documenting unspecified valve malformations, which can be critical for tracking outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding congenital malformations, improving data accuracy and facilitating better patient management. Q23.9 provides a clear framework for documenting unspecified valve malformations, which can be critical for tracking outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding congenital malformations, improving data accuracy and facilitating better patient management. Q23.9 provides a clear framework for documenting unspecified valve malformations, which can be critical for tracking outcomes and resource allocation.

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 is the significance of coding congenital malformations accurately?

Accurate coding of congenital malformations is crucial for appropriate patient management, resource allocation, and research. It ensures that patients receive the necessary interventions and follow-up care while also providing valuable data for public health initiatives and healthcare planning.