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v1.0.0
ICD-10 Guide
ICD-10 CodesQ34.0

Q34.0

Billable

Anomaly of pleura

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

Code Description

ICD-10 Q34.0 is a billable code used to indicate a diagnosis of anomaly of pleura.

Key Diagnostic Point:

Anomaly of the pleura refers to congenital malformations affecting the pleural membranes surrounding the lungs. These anomalies can manifest as pleural effusions, absence of pleura, or abnormal pleural formations. Congenital anomalies of the respiratory system, such as choanal atresia, tracheoesophageal fistula, and lung hypoplasia, often coexist with pleural anomalies. Choanal atresia is characterized by the blockage of the nasal passage, leading to respiratory distress in neonates. Tracheoesophageal fistula involves an abnormal connection between the trachea and esophagus, complicating feeding and breathing. Lung hypoplasia, or underdeveloped lungs, can result from various factors, including congenital diaphragmatic hernia, which may also affect pleural integrity. Accurate coding of these conditions requires a thorough understanding of their clinical presentations and potential complications, as they can significantly impact respiratory function and overall health in pediatric patients.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of pleural anomalies
  • Potential for co-occurrence with other congenital malformations
  • Need for detailed documentation of respiratory function and associated conditions
  • Differentiation from acquired pleural conditions

Audit Risk Factors

  • Inadequate documentation of associated respiratory conditions
  • Failure to specify the type of pleural anomaly
  • Misclassification of congenital versus acquired conditions
  • Lack of clarity in the clinical scenario leading to coding errors

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Documentation must include detailed descriptions of respiratory symptoms, diagnostic imaging results, and any surgical interventions performed.

Common Clinical Scenarios

Common scenarios include newborns presenting with respiratory distress, requiring evaluation for congenital anomalies, and management of associated feeding difficulties.

Billing Considerations

Coders should be aware of the developmental implications of respiratory anomalies and their potential long-term effects on growth and health.

Genetics

Documentation Requirements

Genetic testing results, family history, and any syndromic associations should be documented to support the diagnosis of congenital anomalies.

Common Clinical Scenarios

Scenarios may include genetic counseling for families with a history of congenital anomalies and the evaluation of chromosomal abnormalities linked to respiratory conditions.

Billing Considerations

Consideration of syndromic presentations is crucial, as many congenital respiratory anomalies can be part of broader genetic syndromes.

Coding Guidelines

Inclusion Criteria

Use Q34.0 When
  • Follow the official ICD
  • CM coding guidelines for congenital malformations, ensuring that all relevant clinical information is documented
  • Use additional codes to capture associated conditions and complications

Exclusion Criteria

Do NOT use Q34.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

32551CPT Code

Thoracentesis, needle aspiration of pleural space

Clinical Scenario

Used in cases of pleural effusion to relieve respiratory distress.

Documentation Requirements

Document the indication for the procedure, findings, and any complications.

Specialty Considerations

Pediatric considerations include the size of the needle and sedation requirements.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital anomalies, improving the granularity of data collection and enhancing the ability to track outcomes in pediatric populations.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital anomalies, improving the granularity of data collection and enhancing the ability to track outcomes in pediatric populations.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital anomalies, improving the granularity of data collection and enhancing the ability to track outcomes in pediatric populations.

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 conditions associated with Q34.0?

Common conditions include choanal atresia, tracheoesophageal fistula, and lung hypoplasia, all of which can impact respiratory function and require careful management.