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v1.0.0
ICD-10 Guide
ICD-10 CodesQ43.4

Q43.4

Billable

Duplication of intestine

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

Code Description

ICD-10 Q43.4 is a billable code used to indicate a diagnosis of duplication of intestine.

Key Diagnostic Point:

Duplication of intestine is a rare congenital malformation characterized by the presence of an abnormal segment of intestine that is duplicated. This condition can occur anywhere along the gastrointestinal tract, but it is most commonly found in the ileum. The duplication can lead to various complications, including obstruction, volvulus, and intussusception. Patients may present with symptoms such as abdominal pain, vomiting, and failure to thrive. Diagnosis is typically made through imaging studies such as ultrasound or MRI, which can reveal the duplicated segment. Surgical intervention is often required to remove the duplicated segment and to address any associated complications. The condition may be associated with other congenital anomalies, particularly those affecting the digestive system, such as esophageal atresia, Hirschsprung disease, and imperforate anus. Understanding the implications of intestinal duplication is crucial for pediatric care, as it can significantly impact a child's growth and development.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and symptoms among patients
  • Potential for associated congenital anomalies
  • Need for surgical intervention and follow-up care
  • Diagnostic challenges in imaging interpretation

Audit Risk Factors

  • Inadequate documentation of the condition's severity
  • Failure to document associated congenital anomalies
  • Lack of clarity in surgical procedure descriptions
  • Inconsistent coding of complications

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed clinical notes on growth, development, and any surgical interventions performed.

Common Clinical Scenarios

A pediatric patient presenting with abdominal pain and failure to thrive, leading to imaging that reveals intestinal duplication.

Billing Considerations

Pediatric coders must ensure that all associated congenital anomalies are documented to support the complexity of care provided.

Genetics

Documentation Requirements

Genetic testing results and family history that may indicate a hereditary pattern.

Common Clinical Scenarios

A child with intestinal duplication and a family history of congenital malformations undergoing genetic counseling.

Billing Considerations

Genetic coders should document any chromosomal abnormalities that may be associated with the duplication.

Coding Guidelines

Inclusion Criteria

Use Q43.4 When
  • Follow the official ICD
  • CM guidelines for coding congenital malformations, ensuring that all relevant details are captured, including associated conditions and complications

Exclusion Criteria

Do NOT use Q43.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

44160CPT Code

Resection of small intestine

Clinical Scenario

Used in cases where surgical intervention is required for intestinal duplication.

Documentation Requirements

Operative reports detailing the procedure and findings.

Specialty Considerations

Pediatric surgeons must document the specifics of the resection and any complications.

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 data collection and reimbursement processes for complex cases like intestinal duplication.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of data collection and reimbursement processes for complex cases like intestinal duplication.

Reimbursement & Billing Impact

reimbursement processes for complex cases like intestinal duplication.

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 intestinal duplication?

Common complications include bowel obstruction, intussusception, volvulus, and failure to thrive. These complications necessitate careful monitoring and may require surgical intervention.