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v1.0.0
ICD-10 Guide
ICD-10 CodesQ24.6

Q24.6

Billable

Congenital heart block

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

Code Description

ICD-10 Q24.6 is a billable code used to indicate a diagnosis of congenital heart block.

Key Diagnostic Point:

Congenital heart block is a rare cardiac condition characterized by a disruption in the electrical conduction system of the heart, leading to an abnormal heart rhythm. This condition can be classified into three degrees: first-degree, second-degree, and third-degree (complete) heart block. In congenital cases, the heart block is present at birth and may be associated with other congenital heart defects, such as atrioventricular septal defects or structural abnormalities of the heart. The etiology often involves maternal autoimmune conditions, particularly in cases where maternal antibodies (anti-Ro/SSA and anti-La/SSB) cross the placenta, affecting the fetal heart. Symptoms may vary from asymptomatic to severe bradycardia, which can lead to heart failure or other complications. Diagnosis is typically made through electrocardiography (ECG) and may require further imaging studies to assess associated structural defects. Management may include monitoring, pacemaker insertion, or treatment of underlying conditions. Understanding the interplay between congenital heart block and other congenital malformations of the circulatory system is crucial for effective treatment and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in associated congenital heart defects
  • Need for precise documentation of associated conditions
  • Potential for misclassification with acquired heart block
  • Variability in clinical presentation and severity

Audit Risk Factors

  • Inadequate documentation of associated congenital conditions
  • Misdiagnosis of congenital versus acquired heart block
  • Failure to document maternal health history impacting the fetus
  • Inconsistent coding of severity levels

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation should include detailed history of the child's cardiac symptoms, family history of congenital heart disease, and results from diagnostic tests such as ECG and echocardiography.

Common Clinical Scenarios

Common scenarios include a newborn presenting with bradycardia, a child with a known congenital heart defect undergoing routine monitoring, or a patient requiring pacemaker placement due to symptomatic heart block.

Billing Considerations

Special considerations include the need for ongoing monitoring and potential surgical interventions, as well as the impact of maternal health on the child's condition.

Genetics

Documentation Requirements

Genetic documentation should include family history of congenital heart defects, results from genetic testing, and any identified chromosomal abnormalities that may contribute to the condition.

Common Clinical Scenarios

Genetic counseling scenarios may involve families with a history of congenital heart disease or those with identified genetic syndromes associated with heart block.

Billing Considerations

Considerations include the potential for syndromic associations and the need for comprehensive genetic evaluation in affected families.

Coding Guidelines

Inclusion Criteria

Use Q24.6 When
  • Official coding guidelines for congenital conditions emphasize the importance of accurate documentation of the congenital nature of the condition, associated defects, and any relevant family history
  • Coders should ensure that all relevant clinical details are captured to support the diagnosis

Exclusion Criteria

Do NOT use Q24.6 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

33206CPT Code

Insertion of permanent pacemaker

Clinical Scenario

Used in cases of symptomatic congenital heart block requiring pacing.

Documentation Requirements

Documentation must include indications for pacemaker placement and pre-operative evaluations.

Specialty Considerations

Pediatric considerations include age-appropriate device selection and monitoring.

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 conditions, improving the ability to capture the complexity of congenital heart block and its associations.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital heart conditions, improving the ability to capture the complexity of congenital heart block and its associations.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Congenital Heart Disease

Coding & Billing References

  • •
    American Academy of Pediatrics - Congenital Heart Disease

Frequently Asked Questions

What are the common causes of congenital heart block?

Congenital heart block is often caused by maternal autoimmune diseases, particularly those involving anti-Ro/SSA and anti-La/SSB antibodies. It can also occur in association with congenital heart defects and genetic syndromes.