ICD-10-CM Code Q25.5

Atresia of pulmonary artery

Version 2020 Billable Code POA Exempt

Valid for Submission

Q25.5 is a billable code used to specify a medical diagnosis of atresia of pulmonary artery. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Q25.5 might also be used to specify conditions or terms like atresia of pulmonary artery with septal defect, atresia of pulmonary trunk with absent left pulmonary artery, atresia of pulmonary trunk with absent right pulmonary artery, confluent pulmonary arteries, congenital absence of left pulmonary artery, congenital absence of right pulmonary artery, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

ICD-10:Q25.5
Short Description:Atresia of pulmonary artery
Long Description:Atresia of pulmonary artery

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 Q25.5 are found in the index:


Synonyms

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

  • Atresia of pulmonary artery with septal defect
  • Atresia of pulmonary trunk with absent left pulmonary artery
  • Atresia of pulmonary trunk with absent right pulmonary artery
  • Confluent pulmonary arteries
  • Congenital absence of left pulmonary artery
  • Congenital absence of right pulmonary artery
  • Congenital atresia of pulmonary artery
  • Pulmonary atresia with absent pulmonary artery
  • Pulmonary atresia with confluent pulmonary arteries
  • Pulmonary trunk atresia
  • Solitary aortic trunk with pulmonary atresia

Diagnostic Related Groups

The ICD-10 code Q25.5 is grouped in the following groups for version MS-DRG V37.0 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 10/01/2019 through 09/30/2020.

  • 306 - CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC
  • 307 - CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC

Present on Admission (POA)

Q25.5 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 CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert Q25.5 to ICD-9

  • 747.31 - Pulmon art coarct/atres (Approximate Flag)

Code Classification

  • Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
    • Congenital malformations of the circulatory system (Q20-Q28)
      • Congenital malformations of great arteries (Q25)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

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


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