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2025 ICD-10-CM code Q22

Congenital malformations of pulmonary and tricuspid valves.

This code should not be used on the maternal record. It is specific to the infant born with the congenital malformation.

Medical necessity is established by the presence of a congenital malformation affecting the pulmonary and/or tricuspid valves, causing significant impairment of cardiac function or posing a risk of future complications. This is typically confirmed through diagnostic imaging and clinical evaluation.

Diagnosis and management of congenital heart defects typically fall under the purview of pediatric cardiologists and related specialists. They are responsible for diagnosing the specific malformation, determining its severity, and outlining the appropriate treatment plan, which may involve medication, surgical intervention, or ongoing monitoring.

In simple words: This code represents a birth defect affecting the pulmonary and tricuspid valves of the heart.

Congenital malformations of pulmonary and tricuspid valves.

Example 1: A newborn infant is diagnosed with pulmonary valve stenosis and tricuspid valve regurgitation., A child presents with cyanosis and shortness of breath, and is found to have Ebstein's anomaly of the tricuspid valve., A fetus is diagnosed prenatally with a malformation of the pulmonary valve.

Documentation should include imaging studies (such as echocardiogram, cardiac MRI), cardiac catheterization findings (if performed), and clinical findings describing the specific malformations of the pulmonary and/or tricuspid valves.It should also include any associated symptoms or complications, and the treatment plan.

** This code represents a range of specific malformations affecting the pulmonary and tricuspid valves, including stenosis, atresia, regurgitation, and Ebstein's anomaly. Further specificity can be achieved through the use of subcodes (Q22.0 - Q22.9).

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