ICD-10 code for heart malformation

The ICD-10-CM code for heart malformation is Q24.9 (Congenital malformation of heart, unspecified). The official index lists 1 more specific code, so check the documentation for details such as type, cause, site or severity before settling on Q24.9.

Within Q24, choose Q24.9 (Congenital malformation of heart, unspecified) only when documentation doesn't support a more specific option: Dextrocardia (Q24.0), Levocardia (Q24.1), cor triatriatum (Q24.2), pulmonary infundibular stenosis (Q24.3), congenital subaortic stenosis (Q24.4), malformation of coronary vessels (Q24.5), congenital heart block (Q24.6) and other specified congenital malformations of heart (Q24.8).

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

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) and DRG 307 (Cardiac Congenital and Valvular Disorders without MCC, relative weight 0.9148), in MDC 05 (Diseases and Disorders of the Circulatory System), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.