Q21.0Ventricular septal defect

Q21.0 is the ICD-10-CM diagnosis code for ventricular septal defect. It belongs to category Q21 (congenital malformations of cardiac septa), block Q20-Q28 (congenital malformations of the circulatory system) and chapter 17 (congenital malformations, deformations, chromosomal abnormalities, and genetic disorders). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Within Q21 (congenital malformations of cardiac septa), Q21.0 is specifically for ventricular septal defect. Related codes cover atrial septal defect (Q21.1), atrioventricular septal defect (Q21.2), tetralogy of Fallot (Q21.3), Aortopulmonary septal defect (Q21.4), other congenital malformations of cardiac septa (Q21.8) and congenital malformation of cardiac septum, unspecified (Q21.9).

As a secondary diagnosis it is a CC (complication or comorbidity), which can move an inpatient stay into the "with CC" MS-DRG of its family, unless the principal diagnosis excludes it.

In MS-DRG v44.0, it is part of the grouping logic for DRG 306 (Cardiac Congenital and Valvular Disorders with MCC, relative weight 1.546), DRG 307 (Cardiac Congenital and Valvular Disorders without MCC, relative weight 0.9148), DRG 791 (Prematurity with Major Problems, relative weight 4.1075) and DRG 793 (Full Term Neonate with Major Problems, relative weight 4.2195), in MDC 05 (Diseases and Disorders of the Circulatory System) and MDC 15 (Newborns and Other Neonates with Conditions Originating in the Perinatal Period), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It is exempt from present-on-admission (POA) reporting, so no POA indicator is required.

It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.

Before ICD-10, this condition was coded in ICD-9-CM as 745.4 (ventricular septal defect).