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ICD-10 Guide
ICD-10 CodesQ43.3

Q43.3

Billable

Congenital malformations of intestinal fixation

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

Code Description

ICD-10 Q43.3 is a billable code used to indicate a diagnosis of congenital malformations of intestinal fixation.

Key Diagnostic Point:

Congenital malformations of intestinal fixation refer to a group of conditions where the intestines are improperly anchored within the abdominal cavity. This can lead to complications such as volvulus, intestinal obstruction, and impaired blood supply to the intestines. These malformations can occur in conjunction with other congenital anomalies, particularly those affecting the digestive system. Common associated conditions include esophageal atresia, where the esophagus does not connect properly to the stomach; Hirschsprung disease, characterized by the absence of nerve cells in the colon leading to severe constipation; and imperforate anus, where the anal opening is missing or blocked. Gastroschisis, a defect where the intestines protrude through a hole in the abdominal wall, is also related. These conditions often require surgical intervention and careful management in pediatric patients to ensure proper growth and development.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in associated congenital conditions
  • Need for detailed surgical documentation
  • Potential for multiple procedures related to the same diagnosis
  • Variations in clinical presentation and severity

Audit Risk Factors

  • Inadequate documentation of associated conditions
  • Failure to specify the type of malformation
  • Incorrect linkage of procedures to diagnosis
  • Lack of clarity in surgical reports

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed documentation of the patient's growth, development, and any surgical interventions performed.

Common Clinical Scenarios

Management of a newborn with esophageal atresia requiring surgical repair and follow-up care.

Billing Considerations

Consideration of the patient's overall health status and any comorbidities that may affect treatment.

Genetics

Documentation Requirements

Genetic testing results, family history, and any syndromic associations must be documented.

Common Clinical Scenarios

Genetic counseling for families with a history of congenital malformations.

Billing Considerations

Understanding the genetic basis of congenital conditions and their implications for family planning.

Coding Guidelines

Inclusion Criteria

Use Q43.3 When
  • Follow the official ICD
  • CM coding guidelines for congenital malformations, ensuring accurate documentation of the condition and any associated anomalies
  • Use additional codes as necessary to capture the full clinical picture

Exclusion Criteria

Do NOT use Q43.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

44160CPT Code

Resection of intestine

Clinical Scenario

Used in cases of intestinal obstruction due to congenital malformations.

Documentation Requirements

Surgical reports detailing the procedure and findings.

Specialty Considerations

Pediatric surgical documentation must include age-specific considerations.

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 tracking of congenital conditions and their outcomes.

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 tracking of congenital conditions and their outcomes.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better tracking of congenital conditions and their outcomes.

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 associated conditions with Q43.3?

Common associated conditions include esophageal atresia, Hirschsprung disease, imperforate anus, and gastroschisis. Each of these conditions may require specific coding and documentation to accurately reflect the patient's clinical status.