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v1.0.0
ICD-10 Guide
ICD-10 CodesQ79.1

Q79.1

Billable

Other congenital malformations of diaphragm

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

Code Description

ICD-10 Q79.1 is a billable code used to indicate a diagnosis of other congenital malformations of diaphragm.

Key Diagnostic Point:

Congenital malformations of the diaphragm can lead to significant respiratory distress and other complications in neonates and infants. These malformations may include eventration of the diaphragm, congenital diaphragmatic hernia, or other structural abnormalities that affect the diaphragm's integrity and function. The diaphragm is a critical muscle for respiration, and its malformation can result in impaired lung development, pulmonary hypoplasia, and associated cardiovascular anomalies. Diagnosis is typically made through imaging studies such as ultrasound or chest X-ray, and management may involve surgical intervention, particularly in cases of hernia. Early identification and intervention are crucial to improve outcomes, as these conditions can lead to severe respiratory failure if not addressed promptly. The coding for these conditions requires careful documentation of the specific type of malformation and any associated anomalies, as well as the clinical implications for the patient.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of diaphragm malformations
  • Need for precise documentation of associated anomalies
  • Differentiation from other respiratory conditions
  • Potential for multiple congenital anomalies requiring comprehensive coding

Audit Risk Factors

  • Inadequate documentation of the specific type of malformation
  • Failure to capture associated congenital anomalies
  • Misclassification of the condition due to overlapping symptoms with other respiratory disorders
  • Lack of clarity on the surgical interventions performed

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed clinical notes on respiratory status, imaging results, and any surgical interventions performed.

Common Clinical Scenarios

Neonates presenting with respiratory distress, requiring evaluation for congenital diaphragmatic hernia.

Billing Considerations

Consideration of the infant's gestational age and overall health status when coding.

Genetics

Documentation Requirements

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

Common Clinical Scenarios

Cases where diaphragm malformations are part of a genetic syndrome, requiring comprehensive genetic evaluation.

Billing Considerations

Awareness of chromosomal abnormalities that may co-occur with diaphragm malformations.

Coding Guidelines

Inclusion Criteria

Use Q79.1 When
  • Follow ICD
  • CM guidelines for congenital malformations, ensuring accurate coding based on the specific type of diaphragm malformation and any associated conditions
  • Documentation must support the diagnosis and any interventions performed

Exclusion Criteria

Do NOT use Q79.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

39501CPT Code

Repair of congenital diaphragmatic hernia

Clinical Scenario

Used in cases where surgical intervention is required for diaphragm malformations.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Pediatric surgical documentation must be thorough to support the 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 malformations, improving the ability to capture the complexity of these conditions and their management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital malformations, improving the ability to capture the complexity of these conditions and their management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital malformations, improving the ability to capture the complexity of these conditions and their 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 Q79.1?

Documentation should include detailed clinical notes on the type of diaphragm malformation, associated anomalies, imaging results, and any surgical interventions performed. Ensure that all relevant clinical information is captured to support accurate coding.