2024 ICD-10-CM Diagnosis Code Q25.49

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

• Abnormal course of aortic arch
• Abnormal course of aortic arch and descending aorta
• Abnormality of aortic arch
• Aneurysm of aortic sinus of Valsalva with protrusion into left atrium
• Anomalies of the aorta excluding coarction
• Anomalous common origin of brachiocephalic artery and left common carotid artery
• Anomalous origin of arterial duct from aortic diverticulum
• Anomalous origin of arterial ligament from aortic diverticulum
• Anomalous origin of arterial ligament from retroesophageal aortic diverticulum
• Anomalous origin of the aortic arch
• Aorta to right ventricle tunnel
• Aortic arch centrally descending
• Aortic left ventricular tunnel
• Aortic left ventricular tunnel
• Aortic left ventricular tunnel with right coronary artery from tunnel
• Aortic orifice to posterior right of pulmonary orifice
• Aortic root congenital abnormality
• Aortic sinus of Valsalva aneurysm from noncoronary sinus
• Aortic tunnel
• Aortic tunnel
• Aortic tunnel
• Aortico-left ventricular tunnel with intracardiac aneurysm of septal portion
• Ascending aorta absent
• Cervical aortic arch
• Coarctation of aortic arch
• Common arterial trunk with obstruction of aortic arch
• Common arterial trunk with pulmonary dominance
• Common arterial trunk with pulmonary dominance and interrupted aortic arch
• Congenital abnormalities of thoracic aortic branches
• Congenital abnormality of supraaortic branch of thoracic aorta
• Congenital abnormality of thoracic aorta and pulmonary arteries
• Congenital abnormality of thoracic aorta and pulmonary arteries
• Congenital abnormality of thoracic aorta and pulmonary arteries
• Congenital absence of aorta
• Congenital absence of left pulmonary artery
• Congenital absence of left pulmonary artery
• Congenital aneurysm of aorta
• Congenital anomaly of abdominal aorta
• Congenital anomaly of aorta
• Congenital anomaly of aortic arch
• Congenital anomaly of aortic arch AND/OR descending aorta
• Congenital anomaly of descending thoracic aorta
• Congenital atresia of pulmonary valve
• Congenital dilatation of aorta
• Congenital dilatation of aorta
• Congenital dilation of ascending aorta
• Congenital duplication of aorta
• Congenital malposition of aorta
• Descending aorta anterior and same side as azygos vein with absent inferior vena cava
• Descending aorta anterior and same side as azygos vein with azygos continuity of inferior caval vein
• Developmental malformation of branchial arch
• Developmental malformation of branchial arch
• Dextrotransposition of aorta
• Dextrotransposition of aorta
• Dextrotransposition of aorta
• Interrupted aortic arch
• Interrupted aortic arch
• Interrupted aortic arch between left subclavian and left common carotid artery
• Interruption of aortic arch between subclavian artery and common carotid artery
• Isolation of branch of aortic arch
• Isolation of branch of aortic arch
• Isolation of left subclavian artery
• Isolation of subclavian artery
• Kommerell's diverticulum
• Left aortic arch and right descending aorta
• Major aortopulmonary collateral artery
• Major systemic to pulmonary collateral artery
• Malalignment of aortic sinus in relation to pulmonary sinus
• Neuhauser anomaly
• Obstruction of aortic arch
• Overriding aorta
• Persistent aortic arch convolutions
• Persisting fifth aortic arch
• Persisting fifth aortic arch
• Persisting fifth aortic arch with atresia of fourth arch
• Preductal coarctation of aorta
• Preductal interruption of aorta
• Pseudocoarctation of aorta
• Retroesophageal aortic arch
• Sinus of Valsalva abnormality
• Solitary aortic trunk with pulmonary atresia
• Systemic to pulmonary collateral artery from abdominal aorta
• Systemic to pulmonary collateral artery from descending thoracic aorta
• Vascular ring of aorta
• Vascular ring with left aortic arch
• Vascular ring with left aortic arch and retroesophageal right descending aorta and right arterial duct arising from aortic diverticulum and aberrant right subclavian artery
• Vascular ring with left aortic arch and retrotracheal right patent arterial duct
• Vascular ring with left aortic arch and right arterial duct arising from aberrant retroesophageal right subclavian artery
• Vascular ring with left aortic arch and right arterial duct arising from retroesophageal aortic diverticulum
• Vascular ring with left aortic arch and right arterial duct arising from retroesophageal aortic diverticulum and aberrant right subclavian artery
• Vascular ring with left aortic arch and right arterial duct ligament arising from retroesophageal aortic diverticulum with aberrant right subclavian artery
• Vascular ring with left aortic arch and right arterial ligament
• Vascular ring with left aortic arch and right patent arterial duct
• Vascular ring with left aortic arch to right descending aorta and right arterial ligament
• Vascular ring with left aortic arch to right descending aorta and right patent arterial duct
• Vascular ring with mirror image branching of right aortic arch and left arterial ligament
• Vascular ring with right aortic arch
• Vascular ring with right aortic arch and left arterial duct from anomalous retroesophageal brachiocephalic artery
• Vascular ring with right aortic arch and left arterial duct from anomalous retroesophageal left subclavian artery
• Vascular ring with right aortic arch and left arterial duct from retroesophageal diverticulum of aorta
• Vascular ring with right aortic arch and left arterial duct from retroesophageal diverticulum of aorta
• Vascular ring with right aortic arch and left arterial duct from retroesophageal diverticulum of aorta and anomalous left subclavian artery
• Vascular ring with right aortic arch and left arterial ligament
• Vascular ring with right aortic arch and left arterial ligament
• Vascular ring with right aortic arch and left arterial ligament between left subclavian artery and left common carotid artery
• Vascular ring with right aortic arch and left arterial ligament with anomalous retroesophageal left subclavian artery
• Vascular ring with right aortic arch and left patent arterial duct
• Vascular ring with right aortic arch and right arterial ligament with absent left pulmonary artery
• Vascular ring with right aortic arch and right patent arterial duct with absent left pulmonary artery

Clinical Information

• Interrupted Aortic Arch - a rare congenital cardiovascular disorder characterized by the presence of a gap between the ascending and descending portions of the thoracic aorta. this disorder is often associated with ventricular septal defect, ductus arteriosus, or truncus arteriosus.
• Overriding Aorta - a congenital anatomic anomaly in which the aorta is positioned directly above a ventricular septal defect, thus receiving blood from both the right and left ventricles, resulting in an overall decrease in oxygenated haemoglobin and tissue cyanosis.

Q25.49 is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
306	CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC	05	1.5368
307	CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC	05	0.9426

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Present on Admission (POA)

Q25.49 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	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

Replacement Code

Q2549 replaces the following previously assigned ICD-10-CM code(s):

• Q25.4 - Other congenital malformations of aorta

Convert Q25.49 to ICD-9-CM

• ICD-9-CM Code: 747.29 - Cong anom of aorta NEC
  Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education

Congenital Heart Defects

What are 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 baby's heart doesn't develop normally during pregnancy. Congenital heart defects are the most common type of birth defect.

Congenital heart defects can change the way the heart pumps blood. They may make blood flow too slowly, go the wrong way, or block it completely.

There are many types of congenital heart defects. They can happen in one or more parts of the heart. The most common types are:

• Septal defects ("hole in the heart") - openings in the wall between the left and right sides of the heart
• Heart valve defects - problems with the valves that control the flow of blood through the heart
• Defects in the large blood vessels that carry blood in and out of the heart

Congenital heart defects can range from very mild problems that never need treatment to life-threatening problems at birth. The most serious congenital heart defects are called critical congenital heart disease. Babies with these defects usually need surgery in the first year of life. But the symptoms of milder heart defects may not show up until childhood or adulthood.

What causes congenital heart defects?

Researchers often don't know what causes congenital heart defects. They do know that changes in a baby's genes sometimes cause a heart defect. The changed genes may come from the parents, or the changes may happen during pregnancy.

Who is more likely to have a baby with a congenital heart defect?

Several things may increase the chance that your baby has a congenital heart defect, such as:

• Your health before and during pregnancy, including
  • Having diabetes before pregnancy or developing it in the first 3 months of pregnancy (diabetes that develops later in pregnancy isn't a major risk for heart defects). Carefully controlling your blood sugar before and during pregnancy can lower your baby's risk of congenital heart defects.
  • Having phenylketonuria (PKU), a rare inherited disorder that affects how the body uses a protein in foods. If you have PKU, eating a low-protein diet before getting pregnant can lower your baby's risk of having a congenital heart defect.
  • Having rubella (German measles) during pregnancy.
• Your contact with certain substances during pregnancy, including
  • Smoking or secondhand smoke (breathing smoke from another smoker).
  • Certain medicines, such as angiotensin-converting (ACE) inhibitors for high blood pressure and retinoic acids for acne. If you're pregnant or plan to get pregnant, talk with your health care provider about all the medicines you take.
• Your family history and genetics. In most cases, congenital heart defects don't run in families. But your chance of having a baby with a congenital heart defect does go up if you or the other parent has a congenital heart defect, or if you already have a child with a congenital heart defect.

What are the symptoms of congenital heart defects?

Congenital heart defects don't cause pain. The signs and symptoms are different, depending on the type and number of defects and how serious they are.

Common signs and symptoms of congenital heart defects include:

• Cyanosis - a bluish color to the skin, lips, and fingernails. It happens when there isn't enough oxygen in the blood
• Fatigue - your baby may be unusually sleepy and may become very tired during feedings
• Poor blood flow
• Fast or difficult breathing
• Heart murmur - an unusual sound between heartbeats

What other problems do congenital heart defects cause?

Congenital heart defects don't always cause other problems. If they do, which problems you have would depend on the type and number of defects and how serious the defects are.

Children with congenital heart defects are more likely to:

• Be smaller than other children
• Have problems or delays in mental, and emotional growth, and behavior, such as:
  • Speech and language problems
  • Attention deficit hyperactivity disorders (ADHD)

People with congenital heart defects may develop other health conditions, including:

• Endocarditis - an infection of lining of the heart and valves
• Arrhythmia - a problem with the rate or rhythm of your heartbeat
• Heart failure - when your heart can't pump enough blood to the body
• Pulmonary hypertension - high blood pressure in your lungs
• Kidney and liver disease

How are congenital heart defects diagnosed?

• Before a baby is born, your provider may use ultrasound pictures of the baby's heart to look for heart defects. This is called a fetal echocardiogram. It's done between weeks 18 and 22 of pregnancy.
• During the first few days after birth, all newborns are checked for congenital heart defects. A pulse oximeter is clipped to your baby's hands or feet to measure blood oxygen. If it shows low levels of blood oxygen, more tests will be needed to find out if your baby has a heart defect.
• To diagnose congenital heart defects in babies, children, and adults, a provider may use many tools, including:
  • A physical exam.
  • Certain heart tests to see how the heart is working.
  • Genetic testing to see if certain gene problems caused the defect.

What are the treatments for congenital heart defects?

Treatment depends on the type of congenital heart defect and how serious it is. Possible treatments include:

• Cardiac catheterization to repair simple defects, such as a small hole in the inside wall of the heart. A catheterization uses a thin tube guided through a vein and into the heart.
• Heart surgery may be needed to:
  • Repair defects in the heart and blood vessels.
  • Repair or replace a heart valve.
  • Place a device in the chest to help the heart pump blood.
  • Do a heart transplant.
• Medicine is often used if your baby has a specific type of congenital heart defect called patent ductus arteriosus.

All children and adults who have congenital heart defects need regular follow-up care from a cardiologist (a doctor who specializes in heart diseases) throughout their life, even if their defect was repaired.

Some people may need several heart surgeries or catheterizations over the years. They may also need to take medicines to help their hearts work as well as possible.

NIH: National Heart, Lung, and Blood Institute

[Learn More in MedlinePlus]

Code History

• FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• 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