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v1.0.0
ICD-10 Guide
ICD-10 CodesQ89.7

Q89.7

Billable

Multiple congenital malformations, not elsewhere classified

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

Code Description

ICD-10 Q89.7 is a billable code used to indicate a diagnosis of multiple congenital malformations, not elsewhere classified.

Key Diagnostic Point:

Q89.7 is used to classify cases where a patient presents with multiple congenital malformations that do not fit into specific categories defined by other codes. These malformations can include a variety of anatomical anomalies affecting different systems of the body, such as congenital skin defects (e.g., epidermolysis bullosa), breast malformations (e.g., Poland syndrome), and abnormalities of the spleen (e.g., asplenia or polysplenia). Additionally, adrenal gland malformations, such as congenital adrenal hyperplasia, may also be included under this code. The complexity of these cases often arises from the need to assess the interplay between various malformations and their potential impact on the patient's overall health. Accurate coding requires a thorough understanding of the specific malformations present, their clinical significance, and the potential for associated syndromes or genetic conditions. This code is particularly relevant in pediatric populations, where congenital anomalies are more prevalent and can significantly affect growth and development.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Diverse range of malformations requiring detailed documentation
  • Potential for overlapping syndromes complicating diagnosis
  • Need for comprehensive clinical evaluation to determine all present anomalies
  • Variability in presentation and severity of congenital conditions

Audit Risk Factors

  • Inadequate documentation of all congenital anomalies
  • Failure to link malformations to clinical findings
  • Misclassification of malformations under more specific codes
  • Inconsistent use of terminology in medical records

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation must include detailed descriptions of each congenital anomaly, their clinical implications, and any associated syndromes. Growth and developmental assessments are also critical.

Common Clinical Scenarios

Common scenarios include infants with multiple congenital anomalies presenting for evaluation in the NICU or outpatient pediatric clinics, where comprehensive assessments are necessary.

Billing Considerations

Coders should be aware of the developmental milestones and potential interventions required for children with multiple congenital malformations.

Genetics

Documentation Requirements

Genetic documentation should include family history, genetic testing results, and any syndromic associations with the congenital malformations.

Common Clinical Scenarios

Genetic counseling sessions for families with a history of congenital anomalies or when a child presents with multiple malformations.

Billing Considerations

Consideration of genetic syndromes that may explain the presence of multiple congenital anomalies is crucial for accurate coding.

Coding Guidelines

Inclusion Criteria

Use Q89.7 When
  • Official coding guidelines for congenital conditions emphasize the importance of specificity and the need to document all congenital anomalies present
  • Coders should refer to the ICD
  • CM guidelines for coding congenital malformations and ensure that all relevant clinical information is captured

Exclusion Criteria

Do NOT use Q89.7 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits for children with multiple congenital anomalies.

Documentation Requirements

Documentation must include a review of systems and a detailed examination of the child's condition.

Specialty Considerations

Pediatricians should ensure that all congenital conditions are documented to support the visit.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more detailed coding of congenital malformations, but it has also increased the complexity of coding due to the need for specificity and comprehensive documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of congenital malformations, but it has also increased the complexity of coding due to the need for specificity and comprehensive documentation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more detailed coding of congenital malformations, but it has also increased the complexity of coding due to the need for specificity and comprehensive documentation.

Resources

Clinical References

  • •
    CDC Congenital Malformations

Coding & Billing References

  • •
    CDC Congenital Malformations

Frequently Asked Questions

When should I use Q89.7?

Q89.7 should be used when a patient presents with multiple congenital malformations that do not fit into more specific categories. Ensure that all anomalies are documented to support the use of this code.