2025 ICD-10-CM code Q22.3
Other congenital malformations of pulmonary valve
Medical necessity for procedures or treatments related to this diagnosis must be substantiated by the clinical documentation, showing the impact of the malformation on the patient's health. This may include evidence of reduced exercise tolerance, cyanosis, or other cardiac complications resulting from the pulmonary valve defect.
Diagnosis and management of congenital heart defects fall under the purview of pediatric cardiologists and potentially cardiovascular surgeons if surgical intervention is necessary. Proper documentation of the specific malformation and associated symptoms is crucial for accurate coding and billing.
In simple words: This code describes a birth defect affecting the pulmonary valve, which controls blood flow from the heart to the lungs. The problem could be extra flaps on the valve or another abnormality.
Other congenital malformations of pulmonary valve. This includes conditions such as supernumerary cusps of the pulmonary valve and other unspecified anomalies.
Example 1: A newborn infant is diagnosed with an extra cusp on their pulmonary valve during an echocardiogram, prompting the use of Q22.3., A child undergoing a cardiac catheterization is found to have a congenitally malformed pulmonary valve, not otherwise specified, leading to the assignment of code Q22.3., A teenager experiences shortness of breath and is diagnosed with a pulmonary valve stenosis stemming from a previously undiagnosed congenital malformation. This condition, if not covered by a more specific code, would be documented as Q22.3.
Thorough documentation should include imaging results (such as echocardiograms or cardiac MRI), catheterization findings (if performed), and clinical presentation, including symptoms, signs, and any associated conditions.If the condition affects the mother's health during pregnancy or requires specific interventions during the perinatal period, additional codes may be necessary.
** It's important to differentiate between congenital conditions (present at birth) and acquired conditions affecting the pulmonary valve. This code is exclusively for congenital malformations and should not be used for conditions that develop later in life due to other causes like infection or rheumatic heart disease.
- Payment Status: Active
- Specialties:Pediatric cardiology, cardiovascular surgery
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital, Office, Ambulatory Surgical Center