2027 ICD-10-CM Diagnosis Code Q22.2Congenital pulmonary valve insufficiency
ICD-10-CM Codes›Q00-Q99›Q20-Q28›Q22
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- POA Exempt
- Chronic Condition
Q22.2 is a billable ICD-10-CM diagnosis code for congenital pulmonary valve insufficiency. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 306 through 307. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 52 closely related codes. The code is exempt from POA reporting. Coders also document this condition as congenital insufficiency of pulmonary valve. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Cardiac and circulatory congenital anomalies.
Code Identity
Code Classification
Present on Admission (POA)Billing
Q22.2 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Congenital malformations of the circulatory system (Q20-Q28).
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Congenital insufficiency of pulmonary valve
- Deficiency of pulmonary valve cusp
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Q22.2: its own notes plus those printed at Chapter 17. A note printed at a category, block or chapter applies to every code under it.
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Congenital pulmonary valve regurgitation
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Notes
General instructions on how these codes are used.
- Codes from this chapter are not for use on maternal records
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name Q22.2, its category, or a range that includes it.
Excludes1 1
These codes carry an Excludes1 note naming Q22.2: they are not reported together with it, unless the two conditions are unrelated.
- I37 Nonrheumatic pulmonary valve disorderspulmonary valve disorder specified as congenital (Q22.1, Q22.2, Q22.3)
Excludes2 1
These codes carry an Excludes2 note naming Q22.2: its condition is not part of those codes, and both may be reported when the patient has both.
Use Additional Code 1
These codes say to use an additional code from the note, and Q22.2 is one of the codes named.
- Q87.88 CTNNB1 syndrome
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Congenital Pulmonary Valve Insufficiency
dysfunction of the pulmonary valve characterized by incomplete valve closure that is present at birth.
Patient EducationClinical
Congenital Heart Defects
Congenital heart defects (CHDs) are problems with the structure of the heart. "Congenital" means that that the problems are present at birth. These defects happen when a fetus's heart doesn't develop normally during pregnancy. Congenital heart defects are the most common type of birth defect.
The full article covers:
- What are congenital heart defects?
- What causes congenital heart defects?
- Who is more likely to have a baby with a congenital heart defect?
- What are the symptoms of congenital heart defects?
- What other problems do congenital heart defects cause?
- How are congenital heart defects diagnosed?
- What are the treatments for congenital heart defects?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Q22.2 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Q22.2Overview
What is the ICD-10 code for congenital pulmonary valve insufficiency?
The ICD-10-CM code for congenital pulmonary valve insufficiency is Q22.2 (sometimes written as Q222). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Q22.2 (Congenital malformations of pulmonary and tricuspid valves) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report congenital pulmonary valve insufficiency on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Q22.2 group to?
When congenital pulmonary valve insufficiency is the principal diagnosis on an inpatient stay, it groups to MS-DRG 306, 307, with relative weights from 0.9146 to 1.5457 depending on complications. Higher weights mean higher Medicare reimbursement.
Is Q22.2 a CC or MCC?
CMS lists Q22.2 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 52 closely related codes in its exclusion list.
Is Q22.2 exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for congenital pulmonary valve insufficiency on inpatient claims. The code appears in the Congenital malformations of the circulatory system (Q20-Q28) range of the CMS exempt list.
