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v1.0.0
ICD-10 Guide
ICD-10 CodesQ25.2

Q25.2

Billable

Atresia of aorta

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

Code Description

ICD-10 Q25.2 is a billable code used to indicate a diagnosis of atresia of aorta.

Key Diagnostic Point:

Atresia of the aorta is a rare congenital heart defect characterized by the complete obstruction of the aorta, the major artery that carries oxygenated blood from the heart to the body. This condition typically occurs during fetal development when the aorta fails to form properly, leading to significant hemodynamic consequences. Infants with aortic atresia often present with severe cyanosis and respiratory distress shortly after birth due to inadequate blood flow to the systemic circulation. The condition may be associated with other congenital heart defects, such as ventricular septal defects or coarctation of the aorta. Diagnosis is usually confirmed through echocardiography, which reveals the absence of a functional aorta and may show compensatory mechanisms such as the presence of a patent ductus arteriosus (PDA) or collateral circulation. Management often requires surgical intervention, including procedures to create a new pathway for blood flow, such as aortic reconstruction or heart transplantation in severe cases. Long-term follow-up is essential to monitor for complications and ensure optimal growth and development.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variability in presentation and associated congenital defects
  • Need for detailed documentation of associated conditions
  • Potential for multiple surgical interventions and follow-ups
  • Complexity in distinguishing from similar congenital heart defects

Audit Risk Factors

  • Inadequate documentation of associated congenital anomalies
  • Failure to capture all surgical interventions
  • Misclassification of the severity of the condition
  • Inconsistent use of modifiers for related procedures

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed records of clinical findings, imaging studies, and surgical interventions are essential. Documentation should include the infant's clinical status, any associated congenital defects, and the treatment plan.

Common Clinical Scenarios

Common scenarios include newborns presenting with cyanosis, failure to thrive, and respiratory distress, requiring immediate evaluation and intervention.

Billing Considerations

Coders must be aware of the potential for multiple congenital heart defects and ensure accurate coding of all associated conditions.

Genetics

Documentation Requirements

Genetic counseling notes and family history documentation are crucial, especially if there is a suspected genetic syndrome associated with the congenital heart defect.

Common Clinical Scenarios

Scenarios may include families seeking genetic counseling after a diagnosis of aortic atresia, particularly if there are other congenital anomalies present.

Billing Considerations

Consideration of chromosomal abnormalities that may be associated with congenital heart defects is important for accurate coding.

Coding Guidelines

Inclusion Criteria

Use Q25.2 When
  • According to ICD
  • CM guidelines, congenital malformations should be coded based on the specific anatomical and physiological defects present
  • Coders should ensure that all relevant conditions are documented and coded appropriately, following the guidelines for congenital heart defects

Exclusion Criteria

Do NOT use Q25.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

33533CPT Code

Aortic reconstruction

Clinical Scenario

Used in surgical management of aortic atresia to establish blood flow.

Documentation Requirements

Operative reports detailing the procedure and any complications.

Specialty Considerations

Pediatric cardiology and cardiothoracic surgery documentation must be precise.

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, including aortic atresia, which enhances the ability to capture the complexity of these conditions and their management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital heart defects, including aortic atresia, which enhances the ability to capture the complexity of these conditions and their management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital heart defects, including aortic atresia, which enhances the ability to capture the complexity of these conditions and their management.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Congenital Heart Disease

Coding & Billing References

  • •
    American Academy of Pediatrics - Congenital Heart Disease

Frequently Asked Questions

What is the primary treatment for aortic atresia?

The primary treatment for aortic atresia is surgical intervention, which may include procedures to reconstruct the aorta or create alternative pathways for blood flow. Early diagnosis and management are critical for improving outcomes.