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v1.0.0
ICD-10 Guide
ICD-10 CodesQ25.0

Q25.0

Billable

Patent ductus arteriosus

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

Code Description

ICD-10 Q25.0 is a billable code used to indicate a diagnosis of patent ductus arteriosus.

Key Diagnostic Point:

Patent ductus arteriosus (PDA) is a congenital heart defect characterized by the persistence of the ductus arteriosus, a blood vessel that connects the pulmonary artery to the aorta during fetal development. Normally, this vessel closes shortly after birth, allowing blood to flow through the lungs for oxygenation. When it remains open (patent), it can lead to abnormal blood flow between the aorta and pulmonary artery, resulting in increased workload on the heart and lungs. Symptoms may include rapid breathing, poor feeding, and failure to thrive in infants. Diagnosis is typically made through echocardiography, which can visualize the ductus and assess the degree of left-to-right shunting. Treatment options include pharmacological closure with nonsteroidal anti-inflammatory drugs (NSAIDs) like indomethacin or surgical intervention in cases where medical management is insufficient. PDA is often associated with other congenital heart defects, such as septal defects and coarctation of the aorta, necessitating comprehensive evaluation and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between isolated PDA and PDA associated with other congenital heart defects.
  • Understanding the implications of gestational age on treatment options and outcomes.
  • Variability in clinical presentation and symptomatology based on age and associated conditions.
  • Documentation requirements for both medical and surgical management.

Audit Risk Factors

  • Inadequate documentation of associated congenital conditions.
  • Failure to specify the type of intervention performed (medical vs. surgical).
  • Misclassification of PDA severity based on clinical findings.
  • Lack of follow-up documentation post-intervention.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed clinical notes on symptoms, diagnostic imaging results, and treatment plans.

Common Clinical Scenarios

Infants presenting with respiratory distress or failure to thrive due to PDA.

Billing Considerations

Consideration of gestational age and weight in treatment decisions and coding.

Genetics

Documentation Requirements

Genetic testing results, family history of congenital heart defects, and any syndromic associations.

Common Clinical Scenarios

Assessment of infants with PDA for potential chromosomal abnormalities like Down syndrome.

Billing Considerations

Understanding the genetic implications of congenital heart defects and their associations.

Coding Guidelines

Inclusion Criteria

Use Q25.0 When
  • Follow the official ICD
  • CM guidelines for coding congenital malformations, ensuring accurate documentation of the condition's severity and any associated anomalies

Exclusion Criteria

Do NOT use Q25.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

93580CPT Code

Transcatheter closure of patent ductus arteriosus

Clinical Scenario

Used in cases where medical management fails and surgical intervention is indicated.

Documentation Requirements

Detailed operative report and pre-operative assessment.

Specialty Considerations

Pediatric cardiology 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, including PDA, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

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

Reimbursement & Billing Impact

reimbursement processes.

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 significance of coding PDA accurately?

Accurate coding of PDA is crucial for appropriate reimbursement, tracking of congenital heart defects, and ensuring that patients receive the necessary follow-up care. Misclassification can lead to inadequate treatment and poor outcomes.