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v1.0.0
ICD-10 Guide
ICD-10 CodesQ76.9

Q76.9

Billable

Congenital malformation of bony thorax, unspecified

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

Code Description

ICD-10 Q76.9 is a billable code used to indicate a diagnosis of congenital malformation of bony thorax, unspecified.

Key Diagnostic Point:

Congenital malformations of the bony thorax encompass a range of structural anomalies affecting the rib cage and sternum. These malformations can lead to significant respiratory and cardiovascular complications due to compromised thoracic cavity integrity. Conditions may include pectus excavatum, pectus carinatum, and rib anomalies, which can occur in isolation or as part of syndromic presentations. The severity of these malformations varies widely, with some cases requiring surgical intervention for correction, while others may be managed conservatively. Accurate diagnosis often involves imaging studies such as X-rays or CT scans, and multidisciplinary management may include pediatricians, orthopedic surgeons, and geneticists, particularly when associated with chromosomal abnormalities or syndromes. The unspecified nature of this code indicates that the specific type of malformation is not documented, which can complicate treatment planning and prognosis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of malformations
  • Need for detailed documentation to specify type of malformation
  • Potential association with syndromic conditions requiring additional coding
  • Differentiation from acquired conditions

Audit Risk Factors

  • Inadequate documentation of the specific malformation type
  • Failure to link to associated syndromic conditions
  • Misuse of unspecified codes leading to potential denials
  • Inconsistent coding practices across providers

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Documentation should include detailed descriptions of the malformation, associated symptoms, and any interventions performed.

Common Clinical Scenarios

Pediatric patients presenting with respiratory distress due to thoracic malformations, or those undergoing surgical correction.

Billing Considerations

Consideration of growth and development impacts on thoracic structure and function.

Genetics

Documentation Requirements

Genetic evaluations should document any chromosomal abnormalities or syndromic associations, including family history.

Common Clinical Scenarios

Cases where congenital malformations are part of a genetic syndrome, requiring genetic counseling and testing.

Billing Considerations

Understanding the implications of genetic findings on management and prognosis.

Coding Guidelines

Inclusion Criteria

Use Q76.9 When
  • Follow ICD
  • CM guidelines for coding congenital conditions, ensuring specificity and accuracy in documentation
  • Use additional codes to capture associated conditions or syndromes

Exclusion Criteria

Do NOT use Q76.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit

Clinical Scenario

Used for follow-up visits in patients with congenital thoracic malformations.

Documentation Requirements

Document the patient's history, examination findings, and treatment plan.

Specialty Considerations

Pediatricians should focus on growth and developmental assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding congenital malformations, improving the ability to track and manage these conditions effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding congenital malformations, improving the ability to track and manage these conditions effectively.

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 should I document to support the use of Q76.9?

Document the specific type of congenital malformation, associated symptoms, and any interventions performed. Include details about the patient's history and any syndromic associations.