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v1.0.0
ICD-10 Guide
ICD-10 CodesQ42.8

Q42.8

Billable

Congenital absence, atresia and stenosis of other parts of large intestine

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

Code Description

ICD-10 Q42.8 is a billable code used to indicate a diagnosis of congenital absence, atresia and stenosis of other parts of large intestine.

Key Diagnostic Point:

Congenital absence, atresia, and stenosis of the large intestine can manifest in various forms, leading to significant gastrointestinal complications in affected infants. This condition may involve the complete or partial absence of segments of the large intestine, which can result in obstruction, malabsorption, and failure to thrive. Commonly associated congenital malformations include esophageal atresia, where the esophagus does not connect to the stomach, and Hirschsprung disease, characterized by the absence of nerve cells in the colon, leading to severe constipation or intestinal obstruction. Other related conditions include imperforate anus, where the anal opening is absent or blocked, and gastroschisis, where the intestines protrude outside the body through a defect in the abdominal wall. These congenital anomalies often require surgical intervention and ongoing management to ensure proper growth and development. Accurate coding is essential for appropriate treatment planning and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of congenital conditions
  • Need for detailed clinical documentation to support coding
  • Potential for multiple congenital anomalies requiring comprehensive coding
  • Differentiation between similar codes for accurate representation

Audit Risk Factors

  • Inadequate documentation of the specific type of congenital anomaly
  • Failure to capture associated conditions that may affect treatment
  • Misuse of codes due to overlapping symptoms with other gastrointestinal disorders
  • Inconsistent coding practices across different healthcare settings

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation must include detailed descriptions of the congenital anomaly, associated symptoms, and any surgical interventions performed.

Common Clinical Scenarios

Common scenarios include newborns presenting with feeding difficulties, abdominal distension, or failure to pass meconium, necessitating immediate evaluation.

Billing Considerations

Consideration of growth parameters and nutritional status is crucial in pediatric patients with congenital digestive malformations.

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 anomalies or chromosomal abnormalities.

Billing Considerations

Understanding the genetic basis of congenital conditions can aid in risk assessment and management strategies.

Coding Guidelines

Inclusion Criteria

Use Q42.8 When
  • Follow official coding guidelines for congenital conditions, ensuring accurate documentation of the specific type of anomaly, associated conditions, and any surgical interventions
  • Use additional codes as necessary to capture related diagnoses

Exclusion Criteria

Do NOT use Q42.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

44180CPT Code

Colectomy, partial

Clinical Scenario

Used in cases of congenital atresia requiring surgical intervention.

Documentation Requirements

Document the indication for surgery and any associated findings.

Specialty Considerations

Pediatric surgeons must provide detailed operative reports.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of diagnoses and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of diagnoses and facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of diagnoses and facilitating better patient management.

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 documentation is required for coding congenital absence of the large intestine?

Documentation should include a detailed clinical description of the anomaly, any associated conditions, surgical interventions performed, and follow-up care plans. Ensure that all relevant clinical findings are clearly documented to support the coding.