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v1.0.0
ICD-10 Guide
ICD-10 CodesQ25.8

Q25.8

Billable

Other congenital malformations of other great arteries

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

Code Description

ICD-10 Q25.8 is a billable code used to indicate a diagnosis of other congenital malformations of other great arteries.

Key Diagnostic Point:

Congenital malformations of the great arteries encompass a variety of structural heart defects that can significantly impact the circulatory system. These malformations may include abnormalities such as transposition of the great arteries, truncus arteriosus, and other less common defects. These conditions often arise during fetal development and can lead to serious complications if not diagnosed and treated early. Congenital heart defects (CHDs) are the most prevalent type of birth defect, affecting nearly 1 in 100 live births. The clinical presentation can vary widely, with some infants exhibiting symptoms shortly after birth, while others may remain asymptomatic for months or years. Common associated conditions include septal defects, tetralogy of Fallot, and coarctation of the aorta, which can complicate the clinical picture. Accurate coding of these conditions is crucial for appropriate management and treatment planning, as well as for tracking outcomes and resource allocation in pediatric care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of congenital malformations that fall under this code
  • Need for precise documentation of associated conditions
  • Potential for overlapping symptoms with other congenital heart defects
  • Variability in clinical presentation and severity

Audit Risk Factors

  • Inadequate documentation of the specific type of malformation
  • Failure to capture associated congenital anomalies
  • Misuse of codes for similar conditions
  • Lack of clarity in the clinical narrative

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed clinical notes including physical examination findings, diagnostic imaging results, and treatment plans are essential for accurate coding.

Common Clinical Scenarios

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

Billing Considerations

Consideration of the patient's age, growth patterns, and any surgical interventions is crucial for accurate coding.

Genetics

Documentation Requirements

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

Common Clinical Scenarios

Patients with known genetic syndromes presenting with congenital heart defects require careful coding to reflect both the genetic and cardiac conditions.

Billing Considerations

Understanding the genetic basis of congenital heart defects can aid in accurate coding and management.

Coding Guidelines

Inclusion Criteria

Use Q25.8 When
  • Follow the official ICD
  • CM coding guidelines for congenital conditions, ensuring that all relevant clinical information is captured and that codes are assigned based on the most specific diagnosis available

Exclusion Criteria

Do NOT use Q25.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

33405CPT Code

Repair of coarctation of aorta

Clinical Scenario

Used in cases where surgical intervention is required for coarctation.

Documentation Requirements

Operative reports detailing the procedure and any complications.

Specialty Considerations

Pediatric cardiology should ensure accurate coding of the surgical procedure.

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, improving the ability to track outcomes and resource utilization in pediatric populations.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital heart defects, improving the ability to track outcomes and resource utilization in pediatric populations.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital heart defects, improving the ability to track outcomes and resource utilization in pediatric populations.

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 documentation is required for coding Q25.8?

Comprehensive documentation should include the specific type of congenital malformation, associated conditions, diagnostic imaging results, and treatment plans. This ensures accurate coding and appropriate reimbursement.