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ICD-10 Guide
ICD-10 CodesQ25.42

Q25.42

Billable

Hypoplasia of aorta

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

Code Description

ICD-10 Q25.42 is a billable code used to indicate a diagnosis of hypoplasia of aorta.

Key Diagnostic Point:

Hypoplasia of the aorta is a congenital malformation characterized by an underdeveloped aorta, which can lead to significant hemodynamic consequences. This condition often presents in neonates and can be associated with other congenital heart defects, such as coarctation of the aorta, ventricular septal defects, and tetralogy of Fallot. The severity of hypoplasia can vary, impacting blood flow and oxygen delivery to the body. Symptoms may include cyanosis, difficulty breathing, and signs of heart failure. Diagnosis typically involves echocardiography, which can visualize the aorta's size and structure. Management may require surgical intervention, particularly in severe cases, to restore adequate blood flow and prevent complications. Long-term follow-up is essential to monitor for potential complications, including hypertension and heart failure, as the child grows. Understanding the implications of hypoplasia of the aorta is crucial for pediatricians and cardiologists in providing comprehensive care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of the condition
  • Potential for associated congenital heart defects
  • Need for precise documentation of symptoms and interventions
  • Variability in surgical and non-surgical management approaches

Audit Risk Factors

  • Inadequate documentation of associated congenital conditions
  • Failure to capture the severity of the hypoplasia
  • Misclassification of the condition due to similar codes
  • Lack of follow-up documentation for long-term management

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed clinical notes on the patient's symptoms, diagnostic tests, and treatment plans are essential. Documentation should include any associated congenital defects and the patient's response to treatment.

Common Clinical Scenarios

Common scenarios include a newborn presenting with cyanosis, a child with a history of heart murmurs, or a patient undergoing surgical repair of aortic hypoplasia.

Billing Considerations

Pediatric coders must be aware of the developmental implications of congenital heart defects and the need for multidisciplinary care.

Genetics

Documentation Requirements

Genetic counseling notes should document any family history of congenital heart defects and any genetic testing performed to identify syndromic associations.

Common Clinical Scenarios

Scenarios may include genetic evaluation of a child with hypoplasia of the aorta and associated anomalies, or counseling for parents with a history of congenital heart disease.

Billing Considerations

Genetic coders should consider the potential for chromosomal abnormalities that may be associated with congenital heart defects.

Coding Guidelines

Inclusion Criteria

Use Q25.42 When
  • According to ICD
  • 10 coding guidelines, congenital conditions should be coded based on the specific anatomical and physiological characteristics
  • Coders must ensure accurate documentation of the condition's severity and any associated congenital anomalies

Exclusion Criteria

Do NOT use Q25.42 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

33405CPT Code

Repair of coarctation of aorta

Clinical Scenario

Used in cases where surgical intervention is required for hypoplasia of the aorta.

Documentation Requirements

Operative reports detailing the procedure and any complications.

Specialty Considerations

Pediatric cardiology should ensure accurate coding of surgical interventions.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of data collection and reimbursement processes for congenital heart defects.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of data collection and reimbursement processes for congenital heart defects.

Reimbursement & Billing Impact

reimbursement processes for congenital heart defects.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Congenital Heart Disease

Coding & Billing References

  • •
    American Academy of Pediatrics - Congenital Heart Disease

Frequently Asked Questions

What are the common associated conditions with hypoplasia of the aorta?

Common associated conditions include coarctation of the aorta, ventricular septal defects, and other congenital heart defects. It is essential to document any associated anomalies for accurate coding.