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ICD-10 Guide
ICD-10 CodesQ25.71

Q25.71

Billable

Coarctation of pulmonary artery

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

Code Description

ICD-10 Q25.71 is a billable code used to indicate a diagnosis of coarctation of pulmonary artery.

Key Diagnostic Point:

Coarctation of the pulmonary artery is a congenital heart defect characterized by a narrowing of the pulmonary artery, which can impede blood flow from the right ventricle to the lungs. This condition can lead to increased pressure in the right ventricle and reduced oxygenation of blood. It may occur as an isolated defect or in conjunction with other congenital heart anomalies, such as tetralogy of Fallot or ventricular septal defects. Symptoms may include cyanosis, difficulty breathing, and fatigue during exertion. Diagnosis is typically made through echocardiography, which can visualize the narrowing and assess the severity of the defect. Treatment often involves surgical intervention to repair the coarctation, which may include patching the narrowed area or performing a pulmonary artery banding procedure. Long-term follow-up is essential to monitor for potential complications, such as pulmonary hypertension or right ventricular hypertrophy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of the defect
  • Potential for associated congenital anomalies
  • Need for precise documentation of symptoms and interventions
  • Variations in surgical techniques and outcomes

Audit Risk Factors

  • Inadequate documentation of associated congenital anomalies
  • Failure to specify the severity of the coarctation
  • Misclassification of the defect as a different congenital heart condition
  • Lack of follow-up documentation post-surgery

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed clinical notes on symptoms, diagnostic imaging results, and treatment plans are essential for accurate coding.

Common Clinical Scenarios

Pediatric patients presenting with cyanosis or respiratory distress, requiring echocardiography for diagnosis.

Billing Considerations

Consideration of growth and development impacts on treatment and follow-up care.

Genetics

Documentation Requirements

Genetic testing results and family history documentation are crucial for understanding potential hereditary patterns.

Common Clinical Scenarios

Patients with coarctation of the pulmonary artery undergoing genetic counseling for associated syndromes.

Billing Considerations

Awareness of chromosomal abnormalities that may co-occur with congenital heart defects.

Coding Guidelines

Inclusion Criteria

Use Q25.71 When
  • Follow the official ICD
  • CM guidelines for coding congenital malformations, ensuring accurate documentation of the condition's specifics, associated anomalies, and treatment interventions

Exclusion Criteria

Do NOT use Q25.71 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

33641CPT Code

Repair of coarctation of pulmonary artery

Clinical Scenario

Used during surgical intervention for coarctation of the pulmonary artery.

Documentation Requirements

Surgical notes detailing the procedure and any complications.

Specialty Considerations

Pediatric cardiology should ensure accurate coding of the surgical approach.

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 coarctation of the pulmonary artery, 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 coarctation of the pulmonary artery, 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 are the common symptoms of coarctation of the pulmonary artery?

Common symptoms include cyanosis, difficulty breathing, fatigue during exertion, and in severe cases, heart failure. Early diagnosis and intervention are crucial for improving outcomes.