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2025 ICD-10-CM code Q28.8

Other specified congenital malformations of the circulatory system.

Code Q28.8 should only be used when a more specific code for the congenital malformation is not available. Review official coding guidelines for accurate code assignment.

The medical necessity for treatment of congenital circulatory malformations is determined by the severity of the condition and its impact on the patient's health. Conditions causing significant functional impairment or life-threatening complications meet medical necessity guidelines.

Diagnosing and managing patients with congenital circulatory system malformations falls under the purview of specialists like pediatric cardiologists, cardiovascular surgeons, and geneticists. These professionals are responsible for accurate clinical documentation and the application of appropriate diagnostic tests like echocardiography, angiography, and genetic testing.

In simple words: This code represents birth defects affecting the heart and blood vessels that are not described by other, more specific codes.

This code encompasses congenital malformations of the circulatory system that are not specifically classified elsewhere in the ICD-10-CM. Examples include congenital aneurysm of a specified site NEC and spinal vessel anomaly.

Example 1: A newborn presents with respiratory distress and is found to have a congenital aneurysm in a spinal vessel., A fetus is diagnosed with hydrops fetalis during prenatal ultrasound, and further investigations reveal multiple congenital anomalies of the circulatory system., An infant experiences heart failure and is diagnosed with a complex congenital malformation of the aortic arch not otherwise specified.

Documentation should clearly specify the nature and location of the congenital malformation, along with associated clinical findings. Diagnostic imaging reports, genetic testing results, and operative notes (if applicable) should be included.

** This code is not to be used on maternal records. It is exempt from the POA (Present on Admission) reporting requirement.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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