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ICD-10 Guide
ICD-10 CodesQ22.8

Q22.8

Billable

Other congenital malformations of tricuspid valve

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

Code Description

ICD-10 Q22.8 is a billable code used to indicate a diagnosis of other congenital malformations of tricuspid valve.

Key Diagnostic Point:

Congenital malformations of the tricuspid valve can manifest in various forms, including atresia, stenosis, or dysplasia. These anomalies can lead to significant hemodynamic changes, resulting in right heart failure, arrhythmias, and other complications. The tricuspid valve plays a crucial role in maintaining proper blood flow from the right atrium to the right ventricle, and any malformation can disrupt this process. Patients may present with symptoms such as cyanosis, fatigue, and poor growth. Diagnosis typically involves echocardiography, which can visualize structural abnormalities and assess functional impairment. Management may include medical therapy, surgical intervention, or catheter-based procedures, depending on the severity of the defect and associated anomalies. It is essential to consider the presence of other congenital heart defects, such as septal defects or tetralogy of Fallot, which may coexist and complicate the clinical picture.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of tricuspid valve malformations
  • Need for detailed echocardiographic findings for accurate coding
  • Potential for associated congenital heart defects requiring additional codes
  • Differentiation from acquired heart conditions in pediatric patients

Audit Risk Factors

  • Inadequate documentation of echocardiographic findings
  • Failure to report associated congenital heart defects
  • Misclassification of congenital malformations as acquired conditions
  • Lack of clarity in clinical notes regarding the severity of the defect

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed clinical history, physical examination findings, and results from imaging studies are essential for accurate coding.

Common Clinical Scenarios

Pediatric patients presenting with heart murmurs, failure to thrive, or cyanosis may require evaluation for congenital heart defects.

Billing Considerations

Consideration of growth and developmental milestones is crucial in pediatric patients with congenital heart defects.

Genetics

Documentation Requirements

Genetic testing results, family history of congenital conditions, and any syndromic associations should be documented.

Common Clinical Scenarios

Patients with congenital heart defects may undergo genetic counseling to assess for chromosomal abnormalities or syndromes.

Billing Considerations

Awareness of genetic syndromes associated with congenital heart defects, such as Down syndrome or Turner syndrome, is important for accurate coding.

Coding Guidelines

Inclusion Criteria

Use Q22.8 When
  • Follow the official ICD
  • CM coding guidelines for congenital conditions, ensuring that all relevant clinical information is documented and that codes accurately reflect the patient's diagnosis and any associated conditions

Exclusion Criteria

Do NOT use Q22.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

93306CPT Code

Echocardiography, transthoracic, real-time with interpretation

Clinical Scenario

Used for initial assessment and ongoing monitoring of congenital heart defects.

Documentation Requirements

Echocardiographic reports must detail findings related to tricuspid valve morphology and function.

Specialty Considerations

Pediatric cardiologists may require specific imaging protocols for accurate assessment.

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 accuracy of data collection and reimbursement processes for congenital heart defects.

ICD-9 vs ICD-10

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

Reimbursement & Billing Impact

reimbursement processes for congenital heart defects.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Coding for Congenital Heart Disease

Coding & Billing References

  • •
    American Academy of Pediatrics - Coding for Congenital Heart Disease

Frequently Asked Questions

What are the common associated conditions with tricuspid valve malformations?

Tricuspid valve malformations often coexist with other congenital heart defects, such as atrial septal defects, ventricular septal defects, and tetralogy of Fallot. Genetic syndromes like Down syndrome and Turner syndrome may also be associated.