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v1.0.0
ICD-10 Guide
ICD-10 CodesQ21.22

Q21.22

Billable

Transitional atrioventricular septal defect

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

Code Description

ICD-10 Q21.22 is a billable code used to indicate a diagnosis of transitional atrioventricular septal defect.

Key Diagnostic Point:

Transitional atrioventricular septal defect (AVSD) is a complex congenital heart defect characterized by a combination of atrioventricular septal defect and a single common atrioventricular valve. This condition results in a mixing of oxygenated and deoxygenated blood due to the presence of a defect in the septum that separates the atria and ventricles. The transitional form typically presents with a partial defect, where the atrioventricular valves are not fully formed, leading to varying degrees of obstruction and regurgitation. Patients may exhibit symptoms such as cyanosis, heart failure, and failure to thrive. Diagnosis is often made through echocardiography, which reveals the structural anomalies. Surgical intervention is usually required to correct the defect and improve hemodynamics, and the timing of surgery is critical for optimal outcomes. Long-term follow-up is essential to monitor for potential complications, including arrhythmias and residual defects.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variability in presentation and severity of the defect
  • Need for detailed anatomical descriptions in documentation
  • Potential for associated congenital anomalies
  • Complexity of surgical interventions and follow-up care

Audit Risk Factors

  • Inadequate documentation of the defect's complexity
  • Failure to capture associated anomalies
  • Misclassification of the type of AVSD
  • Inconsistent coding of surgical procedures

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed clinical notes including growth parameters, symptoms, and developmental milestones.

Common Clinical Scenarios

Infants presenting with heart failure symptoms, children with exercise intolerance, and pre-operative assessments.

Billing Considerations

Consideration of age-related anatomical changes and developmental implications.

Genetics

Documentation Requirements

Family history of congenital heart defects, genetic testing results, and syndromic associations.

Common Clinical Scenarios

Genetic counseling for families with a history of congenital heart disease and syndromic presentations.

Billing Considerations

Awareness of chromosomal abnormalities that may co-occur with AVSD, such as Down syndrome.

Coding Guidelines

Inclusion Criteria

Use Q21.22 When
  • Follow the ICD
  • CM guidelines for congenital malformations, ensuring accurate documentation of the defect type, associated conditions, and any surgical interventions performed

Exclusion Criteria

Do NOT use Q21.22 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

33533CPT Code

Repair of atrioventricular septal defect

Clinical Scenario

Used during surgical intervention for transitional AVSD.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Pediatric cardiology and cardiothoracic surgery documentation standards.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital heart defects, improving the accuracy of data collection and reimbursement for complex cases like transitional AVSD.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital heart defects, improving the accuracy of data collection and reimbursement for complex cases like transitional AVSD.

Reimbursement & Billing Impact

reimbursement for complex cases like transitional AVSD.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Congenital Heart Disease

Coding & Billing References

  • •
    American Academy of Pediatrics - Congenital Heart Disease

Frequently Asked Questions

What is the difference between transitional AVSD and complete AVSD?

Transitional AVSD involves a partial defect with a common atrioventricular valve, while complete AVSD has a fully formed common valve and a complete defect in the septum, leading to more severe hemodynamic consequences.