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ICD-10 Guide
ICD-10 CodesChapter 17: Congenital malformations and chromosomal abnormalitiesQ83

Q83

Non-billable

Congenital malformations of breast

Chapter 17:Congenital malformations and chromosomal abnormalities

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 Q83 is a used to indicate a diagnosis of congenital malformations of breast.

Key Diagnostic Point:

The ICD-10 Level 1 Category code Q83 pertains to congenital malformations of the breast, which encompasses a variety of conditions that affect the development of breast tissue. These malformations can include conditions such as hypoplasia (underdevelopment), aplasia (absence of breast tissue), and other structural anomalies that may be present at birth. The clinical significance of these conditions can vary widely, from mild cosmetic concerns to more severe implications that may affect breastfeeding or require surgical intervention. Understanding these malformations is crucial for healthcare providers in order to offer appropriate management and treatment options for affected individuals.

  • In clinical practice, accurate coding of congenital breast malformations is essential for proper patient care, as it influences treatment decisions and potential surgical interventions. Documentation must clearly reflect the specific type of malformation, its severity, and any associated complications. This category is particularly relevant for pediatricians, surgeons, and specialists in congenital disorders, as they often encounter these conditions in their patient populations. Proper coding ensures that patients receive the necessary follow-up and management, which can significantly impact their quality of life and overall health outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of conditions covered
  • Need for precise documentation
  • Potential for surgical intervention

Audit Risk Factors

  • Inadequate documentation
  • Misclassification of malformations
  • Failure to capture associated conditions

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Plastic Surgery

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical impact of the Q83 category is significant, as it addresses congenital malformations that can affect a patient's physical and psychological well-being. Early identification and management of these conditions can lead to improved health outcomes, including successful breastfeeding and enhanced self-esteem in affected individuals. Additionally, understanding the prevalence and types of congenital breast malformations can inform public health initiatives aimed at early detection and intervention.
From an administrative perspective, accurate coding of Q83 can influence healthcare trends, resource allocation, and quality measures within healthcare systems. Tracking the incidence of these conditions can help identify population health trends and inform healthcare policies aimed at improving care for individuals with congenital anomalies. As awareness and understanding of congenital breast malformations grow, healthcare providers can better address the needs of affected patients and their families.

ICD-9 vs ICD-10

The clinical impact of the Q83 category is significant, as it addresses congenital malformations that can affect a patient's physical and psychological well-being. Early identification and management of these conditions can lead to improved health outcomes, including successful breastfeeding and enhanced self-esteem in affected individuals. Additionally, understanding the prevalence and types of congenital breast malformations can inform public health initiatives aimed at early detection and intervention. From an administrative perspective, accurate coding of Q83 can influence healthcare trends, resource allocation, and quality measures within healthcare systems. Tracking the incidence of these conditions can help identify population health trends and inform healthcare policies aimed at improving care for individuals with congenital anomalies. As awareness and understanding of congenital breast malformations grow, healthcare providers can better address the needs of affected patients and their families.

Reimbursement & Billing Impact

Reimbursement may vary based on the complexity of the condition and the treatments rendered. It is essential to use the correct CPT codes that correspond to the procedures performed, and to provide comprehensive documentation that justifies the medical necessity of the services.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for Q83

Coding & Billing References

  • •
    Official ICD-10 Guidelines for Q83

Frequently Asked Questions

What conditions are included in Q83?

Q83 includes congenital malformations such as breast hypoplasia, aplasia, and other structural anomalies affecting breast tissue development.

When should I use Q83 codes?

Q83 codes should be used when documenting congenital breast malformations identified at birth or during early childhood, particularly when they impact health or require treatment.

What documentation is required for Q83?

Documentation should include a clear description of the malformation, any associated symptoms, and the clinical assessment findings that support the diagnosis.