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v1.0.0
ICD-10 Guide
ICD-10 CodesQ26.1

Q26.1

Billable

Persistent left superior vena cava

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

Code Description

ICD-10 Q26.1 is a billable code used to indicate a diagnosis of persistent left superior vena cava.

Key Diagnostic Point:

Persistent left superior vena cava (PLSVC) is a congenital vascular anomaly characterized by the presence of a left superior vena cava that drains into the right atrium, either directly or via the coronary sinus. This condition occurs due to the failure of the left anterior cardinal vein to regress during embryonic development. PLSVC is often asymptomatic but can be associated with other congenital heart defects, such as atrial septal defects (ASD) or ventricular septal defects (VSD). In pediatric patients, it may lead to complications such as arrhythmias or difficulties in central venous access. Diagnosis is typically made through echocardiography or cardiac MRI, which can visualize the abnormal venous return. Management may involve monitoring or surgical intervention, particularly if associated with significant hemodynamic compromise or other congenital heart defects. Understanding the implications of PLSVC is crucial for pediatricians and cardiologists, especially in the context of congenital heart disease, where accurate coding and documentation are essential for patient care and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and associated congenital defects
  • Need for precise documentation of associated conditions
  • Potential for misdiagnosis with other vascular anomalies
  • Complexity in coding when multiple congenital conditions are present

Audit Risk Factors

  • Inadequate documentation of associated congenital heart defects
  • Failure to specify the type of venous drainage (direct vs. via coronary sinus)
  • Misclassification of PLSVC as a more severe condition
  • Inconsistent coding practices across different healthcare settings

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed documentation of the patient's history, physical examination findings, and any associated congenital anomalies is essential. Pediatric coders should ensure that all relevant diagnostic tests and imaging studies are documented.

Common Clinical Scenarios

Common scenarios include a newborn diagnosed with PLSVC during routine echocardiography or a child presenting with unexplained arrhythmias where PLSVC is discovered incidentally.

Billing Considerations

Pediatric coders must be aware of the potential for PLSVC to coexist with other congenital heart defects, necessitating careful coding to reflect the full clinical picture.

Genetics

Documentation Requirements

Genetic counseling notes and family history should be documented, especially if PLSVC is part of a syndrome or associated with chromosomal abnormalities.

Common Clinical Scenarios

Scenarios may include a family with a history of congenital heart disease seeking genetic counseling or a child with PLSVC undergoing genetic testing for syndromic associations.

Billing Considerations

Genetic coders should consider the implications of PLSVC in the context of broader genetic syndromes, ensuring accurate coding for both the condition and any associated genetic findings.

Coding Guidelines

Inclusion Criteria

Use Q26.1 When
  • According to ICD
  • CM guidelines, congenital malformations should be coded based on the specific anatomical and physiological characteristics
  • Coders should ensure that all relevant congenital conditions are documented to support the use of Q26

Exclusion Criteria

Do NOT use Q26.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

93306CPT Code

Echocardiography, transthoracic, real-time with interpretation and report

Clinical Scenario

Used to evaluate PLSVC and associated congenital heart defects.

Documentation Requirements

Documentation of indications for echocardiography and findings related to PLSVC.

Specialty Considerations

Pediatric cardiologists should ensure that all relevant findings are documented 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 conditions like PLSVC, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

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

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    Congenital Heart Disease: A Pediatric Perspective

Coding & Billing References

  • •
    Congenital Heart Disease: A Pediatric Perspective

Frequently Asked Questions

What are the common complications associated with persistent left superior vena cava?

Common complications include arrhythmias, difficulties with central venous access, and potential hemodynamic issues if associated with other congenital heart defects. Regular monitoring and evaluation are essential for managing these risks.