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ICD-10 Guide
ICD-10 CodesQ26.8

Q26.8

Billable

Other congenital malformations of great veins

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

Code Description

ICD-10 Q26.8 is a billable code used to indicate a diagnosis of other congenital malformations of great veins.

Key Diagnostic Point:

Congenital malformations of the great veins can significantly impact the circulatory system, leading to various complications. These malformations may include anomalies such as persistent left superior vena cava, anomalous pulmonary venous return, or other structural defects affecting the great veins. These conditions can lead to inadequate blood flow, increased pressure in the heart, and potential heart failure if not diagnosed and managed appropriately. The clinical presentation often varies, with some patients exhibiting symptoms early in life, while others may remain asymptomatic until later in childhood or adulthood. Diagnosis typically involves imaging studies such as echocardiography, MRI, or CT scans to visualize the vascular structures and assess blood flow. Treatment options may include surgical interventions to correct the malformations or manage associated congenital heart defects, such as septal defects or tetralogy of Fallot. Accurate coding of these conditions is crucial for appropriate reimbursement and to ensure that patients receive the necessary care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of malformations
  • Need for detailed imaging studies for accurate diagnosis
  • Potential for co-occurring congenital heart defects
  • Documentation requirements for surgical interventions

Audit Risk Factors

  • Inadequate documentation of the specific type of malformation
  • Failure to report associated congenital heart defects
  • Misclassification of the severity of the condition
  • Lack of imaging study documentation

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation should include detailed descriptions of symptoms, imaging results, and treatment plans. Growth and developmental assessments are also critical.

Common Clinical Scenarios

Common scenarios include infants presenting with cyanosis, failure to thrive, or respiratory distress due to congenital heart defects.

Billing Considerations

Consideration must be given to the age of the patient and the potential for late-presenting symptoms in older children.

Genetics

Documentation Requirements

Genetic documentation should include family history, genetic testing results, and any syndromic associations with congenital malformations.

Common Clinical Scenarios

Scenarios may involve genetic counseling for families with a history of congenital heart defects or chromosomal abnormalities.

Billing Considerations

Genetic syndromes may be associated with multiple congenital anomalies, necessitating comprehensive coding.

Coding Guidelines

Inclusion Criteria

Use Q26.8 When
  • Official coding guidelines for congenital and chromosomal conditions emphasize the importance of specificity in documentation, the need for comprehensive clinical evaluations, and the requirement to capture all relevant diagnoses and procedures

Exclusion Criteria

Do NOT use Q26.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

33533CPT Code

Repair of coarctation of aorta

Clinical Scenario

Used in cases where a patient with a great vein anomaly also has coarctation requiring surgical intervention.

Documentation Requirements

Operative reports detailing the procedure and pre-operative imaging studies.

Specialty Considerations

Pediatric cardiology may require additional documentation for congenital heart defects.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital malformations, improving 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 malformations, improving the ability to capture the complexity of these conditions and their management.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the common congenital malformations of great veins?

Common congenital malformations of great veins include persistent left superior vena cava, anomalous pulmonary venous return, and other structural anomalies that can affect blood flow and oxygenation.