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v1.0.0
ICD-10 Guide
ICD-10 CodesQ43.0

Q43.0

Billable

Meckel's diverticulum (displaced) (hypertrophic)

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

Code Description

ICD-10 Q43.0 is a billable code used to indicate a diagnosis of meckel's diverticulum (displaced) (hypertrophic).

Key Diagnostic Point:

Meckel's diverticulum is a congenital anomaly characterized by the presence of a diverticulum in the ileum, which is a remnant of the embryonic yolk sac. This diverticulum can be displaced or hypertrophic, leading to complications such as intestinal obstruction, hemorrhage, or inflammation. In pediatric patients, it is often asymptomatic but can present with abdominal pain, rectal bleeding, or signs of bowel obstruction. Diagnosis typically involves imaging studies such as ultrasound or CT scans, and management may require surgical intervention. Understanding the implications of this condition is crucial for pediatric care, as it can significantly impact the digestive system's functionality and the child's overall health. The coding for Meckel's diverticulum requires careful attention to detail, particularly in distinguishing it from other congenital malformations of the digestive system, such as esophageal atresia or Hirschsprung disease.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between displaced and non-displaced Meckel's diverticulum
  • Identifying associated complications such as obstruction or hemorrhage
  • Understanding the relationship with other congenital digestive anomalies
  • Navigating documentation requirements for surgical interventions

Audit Risk Factors

  • Inadequate documentation of symptoms or complications
  • Failure to specify the type of Meckel's diverticulum
  • Misclassification with other congenital digestive disorders
  • Lack of clarity in surgical documentation

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation must include detailed clinical notes on symptoms, diagnostic imaging results, and treatment plans.

Common Clinical Scenarios

Common scenarios include a child presenting with abdominal pain and subsequent imaging revealing Meckel's diverticulum.

Billing Considerations

Pediatric coders should be aware of growth and developmental factors that may influence the presentation of congenital conditions.

Genetics

Documentation Requirements

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

Common Clinical Scenarios

Genetic counseling may be necessary for families with a history of congenital malformations.

Billing Considerations

Coders should consider potential chromosomal abnormalities that may co-occur with congenital digestive disorders.

Coding Guidelines

Inclusion Criteria

Use Q43.0 When
  • Follow the official ICD
  • CM coding guidelines for congenital malformations, ensuring specificity in documentation and coding for associated conditions

Exclusion Criteria

Do NOT use Q43.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

44160CPT Code

Laparoscopic resection of Meckel's diverticulum

Clinical Scenario

Used when surgical intervention is required for symptomatic Meckel's diverticulum.

Documentation Requirements

Document indications for surgery, findings during the procedure, and postoperative care.

Specialty Considerations

Pediatric surgeons should ensure accurate coding reflecting the complexity of the procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding congenital conditions, including Meckel's diverticulum, which aids in better tracking and management of these cases.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding congenital conditions, including Meckel's diverticulum, which aids in better tracking and management of these cases.

Reimbursement & Billing Impact

reimbursement.

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 complications associated with Meckel's diverticulum?

Common complications include intestinal obstruction, diverticulitis, and gastrointestinal bleeding. These complications can lead to significant morbidity if not addressed promptly.