2021 ICD-10-CM Code Q21.3
Tetralogy of Fallot
Valid for Submission
Q21.3 is a billable diagnosis code used to specify a medical diagnosis of tetralogy of fallot. The code Q21.3 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.
The ICD-10-CM code Q21.3 might also be used to specify conditions or terms like agenesis of artery, anterior deviation of infundibular septum of fallot type, atrioventricular septal defect associated with tetralogy of fallot, congenital abnormality of thoracic aorta and pulmonary arteries, congenital absence of pulmonary valve , dextraposition of aorta in fallot's tetralogy, etc. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
Code Classification
Tabular List of Diseases and Injuries
The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code Q21.3:
Inclusion Terms
Inclusion TermsThese terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- Ventricular septal defect with pulmonary stenosis or atresia, dextroposition of aorta and hypertrophy of right ventricle.
Index to Diseases and Injuries
The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code Q21.3 are found in the index:
- - Anomaly, anomalous (congenital) (unspecified type) - Q89.9
- - heart - Q24.9
- - septum - Q21.9
- - tetralogy of Fallot - Q21.3
- - heart - Q24.9
- - Dextraposition, aorta - Q20.3
- - in tetralogy of Fallot - Q21.3
- - Fallot's
- - tetrad or tetralogy - Q21.3
- - Hypertrophy, hypertrophic
- - ventricle, ventricular (heart) - See Also: Hypertrophy, cardiac;
- - in tetralogy of Fallot - Q21.3
- - ventricle, ventricular (heart) - See Also: Hypertrophy, cardiac;
- - Stenosis, stenotic (cicatricial) - See Also: Stricture;
- - Tetralogy of Fallot - Q21.3
Approximate Synonyms
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Agenesis of artery
- Anterior deviation of infundibular septum of Fallot type
- Atrioventricular septal defect associated with tetralogy of Fallot
- Congenital abnormality of thoracic aorta and pulmonary arteries
- Congenital absence of pulmonary valve
- Dextraposition of aorta in Fallot's tetralogy
- Fallot complex with intellectual disability and growth delay syndrome
- Growth retardation
- Pulmonary atresia with ventricular septal defect
- Pulmonary atresia with ventricular septal defect
- Pulmonary atresia with ventricular septal defect of Fallot type
- Pulmonary valve agenesis, tetralogy of Fallot, absence of ductus arteriosus syndrome
- Tetralogy of Fallot
- Tetralogy of Fallot
- Tetralogy of Fallot with absent pulmonary valve
- Tetralogy of Fallot with pulmonary atresia
- Tetralogy of Fallot with pulmonary atresia and systemic-to-pulmonary collateral artery
- Tetralogy of Fallot with pulmonary stenosis
- Ventricular septal defect in Fallot's tetralogy
Clinical Information
- TETRALOGY OF FALLOT-. a combination of congenital heart defects consisting of four key features including ventricular septal defects; pulmonary stenosis; right ventricular hypertrophy; and a dextro positioned aorta. in this condition blood from both ventricles oxygen rich and oxygen poor is pumped into the body often causing cyanosis.
Diagnostic Related Groups - MS-DRG Mapping
The ICD-10 code Q21.3 is grouped in the following groups for version MS-DRG V38.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). applicable from 10/01/2020 through 09/30/2021.
Present on Admission (POA)
Q21.3 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here .
CMS POA Indicator Options and Definitions
POA Indicator Code | POA Reason for Code | CMS will pay the CC/MCC DRG? |
---|---|---|
Y | Diagnosis was present at time of inpatient admission. | YES |
N | Diagnosis was not present at time of inpatient admission. | NO |
U | Documentation insufficient to determine if the condition was present at the time of inpatient admission. | NO |
W | Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission. | YES |
1 | Unreported/Not used - Exempt from POA reporting. | NO |
Convert Q21.3 to ICD-9 Code
- 745.2 - Tetralogy of fallot
Information for Patients
Congenital Heart Defects
A congenital heart defect is a problem with the structure of the heart. It is present at birth. Congenital heart defects are the most common type of birth defect. The defects can involve the walls of the heart, the valves of the heart, and the arteries and veins near the heart. They can disrupt the normal flow of blood through the heart. The blood flow can slow down, go in the wrong direction or to the wrong place, or be blocked completely.
Doctors use a physical exam and special heart tests to diagnose congenital heart defects. They often find severe defects during pregnancy or soon after birth. Signs and symptoms of severe defects in newborns include
- Rapid breathing
- Cyanosis - a bluish tint to the skin, lips, and fingernails
- Fatigue
- Poor blood circulation
Many congenital heart defects cause few or no signs and symptoms. They are often not diagnosed until children are older.
Many children with congenital heart defects don't need treatment, but others do. Treatment can include medicines, catheter procedures, surgery, and heart transplants. The treatment depends on the type of the defect, how severe it is, and a child's age, size, and general health.
NIH: National Heart, Lung, and Blood Institute
- Atrial septal defect (Medical Encyclopedia)
- Bicuspid aortic valve (Medical Encyclopedia)
- Congenital heart defect corrective surgeries (Medical Encyclopedia)
- Congenital heart disease (Medical Encyclopedia)
- Cyanotic heart disease (Medical Encyclopedia)
- Dextrocardia (Medical Encyclopedia)
- Echocardiogram -- children (Medical Encyclopedia)
- Heart murmurs and other sounds (Medical Encyclopedia)
- Patent ductus arteriosus (Medical Encyclopedia)
- Ventricular septal defect (Medical Encyclopedia)
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Critical congenital heart disease Critical congenital heart disease (CCHD) is a term that refers to a group of serious heart defects that are present from birth. These abnormalities result from problems with the formation of one or more parts of the heart during the early stages of embryonic development. CCHD prevents the heart from pumping blood effectively or reduces the amount of oxygen in the blood. As a result, organs and tissues throughout the body do not receive enough oxygen, which can lead to organ damage and life-threatening complications. Individuals with CCHD usually require surgery soon after birth.Although babies with CCHD may appear healthy for the first few hours or days of life, signs and symptoms soon become apparent. These can include an abnormal heart sound during a heartbeat (heart murmur), rapid breathing (tachypnea), low blood pressure (hypotension), low levels of oxygen in the blood (hypoxemia), and a blue or purple tint to the skin caused by a shortage of oxygen (cyanosis). If untreated, CCHD can lead to shock, coma, and death. However, most people with CCHD now survive past infancy due to improvements in early detection, diagnosis, and treatment.Some people with treated CCHD have few related health problems later in life. However, long-term effects of CCHD can include delayed development and reduced stamina during exercise. Adults with these heart defects have an increased risk of abnormal heart rhythms, heart failure, sudden cardiac arrest, stroke, and premature death.Each of the heart defects associated with CCHD affects the flow of blood into, out of, or through the heart. Some of the heart defects involve structures within the heart itself, such as the two lower chambers of the heart (the ventricles) or the valves that control blood flow through the heart. Others affect the structure of the large blood vessels leading into and out of the heart (including the aorta and pulmonary artery). Still others involve a combination of these structural abnormalities.People with CCHD have one or more specific heart defects. The heart defects classified as CCHD include coarctation of the aorta, double-outlet right ventricle, D-transposition of the great arteries, Ebstein anomaly, hypoplastic left heart syndrome, interrupted aortic arch, pulmonary atresia with intact septum, single ventricle, total anomalous pulmonary venous connection, tetralogy of Fallot, tricuspid atresia, and truncus arteriosus.
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Code History
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)