2026 ICD-10-CM Diagnosis Code Q22.5Ebstein's anomaly

ICD-10-CM Codes›Q00-Q99›Q20-Q28›Q22

ICD-10-CM Q22.5
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Q22.5 is a billable ICD-10-CM diagnosis code for Ebstein's anomaly. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 306 through 307. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Cardiac and circulatory congenital anomalies.

Code Identity

ICD-10-CM Code
Q22.5
Billable Status
Yes — Valid for Submission
Code Describes
Ebstein's anomaly
Short Description
Ebstein's anomaly
Same as the full description in the CMS dataset.
Parent Code
Q22
Congenital malformations of pulmonary and tricuspid valves

Code Classification

ChapterQ00-Q99Congenital malformations, deformations and chromosomal abnormalities
SectionQ20-Q28Congenital malformations of the circulatory system
CategoryQ22Congenital malformations of pulmonary and tricuspid valves
This CodeQ22.5Ebstein's anomaly

Present on Admission (POA)Billing

Q22.5 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Abnormal atrioventricular connection - biventricular
  • Congenital abnormality of tricuspid leaflet
  • Discordant atrioventricular connection
  • Ebstein's anomaly
  • Ebstein's anomaly of common atrioventricular valve
  • Ebstein's anomaly of left atrioventricular valve
  • Ebstein's anomaly of left atrioventricular valve in functionally univentricular heart
  • Ebstein's anomaly of left sided tricuspid valve with discordant atrioventricular connections
  • Ebstein's anomaly of right atrioventricular valve
  • Ebstein's anomaly of right atrioventricular valve in functionally univentricular heart
  • Ebstein's anomaly of tricuspid valve with atrialization of right ventricular chamber
  • Ebstein's anomaly with atrial septal defect
  • Ebstein's anomaly with functional tricuspid stenosis
  • Functionally univentricular heart

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Abnormal, abnormality, abnormalities
      • Ebstein
    • Anomaly, anomalous(congenital) (unspecified type)
      • Ebstein's (heart) (tricuspid valve)
    • Anomaly, anomalous(congenital) (unspecified type)
      • tricuspid (leaflet) (valve)
        • Ebstein's
    • Deformity
      • tricuspid (leaflets) (valve)
        • Ebstein's
    • Disease, diseased
      • Ebstein's heart
    • Ebstein's anomaly or syndrome(heart)
    • Syndrome
      • Ebstein's

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR MAL001
Cardiac and circulatory congenital anomalies
Default principal diagnosis: inpatient Yes · outpatient Yes

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 Q22.5 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
746.2 Ebstein's anomaly
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Q22.5Overview

Is Q22.5 (Congenital malformations of pulmonary and tricuspid valves) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report Ebstein's anomaly on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does Q22.5 group to?

When Ebstein's anomaly is the principal diagnosis on an inpatient stay, it groups to MS-DRG 306, 307, with relative weights from 0.9132 to 1.5758 depending on complications. Higher weights mean higher Medicare reimbursement.

Is Q22.5 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 Ebstein's anomaly on inpatient claims.

What is the ICD-9 equivalent of Q22.5?

Under the General Equivalence Mappings, Ebstein's anomaly converts to ICD-9-CM 746.2 (Ebstein's anomaly). The mapping is a direct match.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.