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ICD-10 Guide
ICD-10 CodesQ25.79

Q25.79

Billable

Other congenital malformations of pulmonary artery

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

Code Description

ICD-10 Q25.79 is a billable code used to indicate a diagnosis of other congenital malformations of pulmonary artery.

Key Diagnostic Point:

Congenital malformations of the pulmonary artery encompass a variety of structural anomalies that can significantly impact pulmonary circulation and overall cardiovascular function. These malformations may include conditions such as pulmonary artery stenosis, atresia, or other structural defects that affect the normal flow of blood from the right ventricle to the lungs. Patients may present with symptoms such as cyanosis, difficulty breathing, and failure to thrive, particularly in infancy. Diagnosis typically involves imaging studies such as echocardiography, MRI, or CT scans to visualize the anatomy and assess the severity of the malformation. Treatment options may vary from medical management to surgical interventions, depending on the specific type and severity of the malformation. Early detection and intervention are crucial for improving outcomes in affected individuals, particularly in pediatric populations where growth and development can be significantly impacted by these conditions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of malformations
  • Need for detailed imaging and diagnostic documentation
  • Potential for coexisting congenital heart defects
  • Differentiation from acquired conditions

Audit Risk Factors

  • Inadequate documentation of the specific type of malformation
  • Failure to document associated congenital heart defects
  • Misclassification of the severity of the condition
  • Lack of clarity in imaging reports

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation should include growth parameters, developmental milestones, and specific symptoms related to the congenital malformation.

Common Clinical Scenarios

Common scenarios include infants presenting with cyanosis or respiratory distress, requiring echocardiographic evaluation.

Billing Considerations

Coders should be aware of the age-related implications of congenital heart defects and their management in pediatric patients.

Genetics

Documentation Requirements

Genetic documentation should include family history, genetic testing results, and any syndromic associations with congenital malformations.

Common Clinical Scenarios

Scenarios may involve genetic counseling for families with a history of congenital heart defects or syndromes associated with pulmonary artery anomalies.

Billing Considerations

Consideration of chromosomal abnormalities that may co-occur with congenital heart defects is essential for accurate coding.

Coding Guidelines

Inclusion Criteria

Use Q25.79 When
  • According to ICD
  • 10 coding guidelines, congenital malformations should be coded based on the specific anatomical defect and its clinical implications
  • Coders must ensure that all relevant details are documented to support the diagnosis and any associated procedures

Exclusion Criteria

Do NOT use Q25.79 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 evaluation of suspected congenital heart defects.

Documentation Requirements

Documentation must include indications for the echocardiogram and findings related to pulmonary artery anatomy.

Specialty Considerations

Pediatric cardiology may require additional details on growth and development.

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. This specificity aids in better understanding the prevalence and management of congenital conditions.

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. This specificity aids in better understanding the prevalence and management of congenital conditions.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better understanding the prevalence and management of congenital conditions.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the common congenital malformations of the pulmonary artery?

Common congenital malformations include pulmonary artery stenosis, atresia, and other structural anomalies that can affect blood flow from the heart to the lungs. These conditions often require careful evaluation and management to ensure optimal outcomes.