2024 ICD-10-CM Diagnosis Code Q25.6

Stenosis of pulmonary artery

ICD-10-CM Code:
Q25.6
Short Description:
Stenosis of pulmonary artery
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Chronic
Code Navigator:

Code Classification

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

Q25.6 is a billable diagnosis code used to specify a medical diagnosis of stenosis of pulmonary artery. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

Approximate Synonyms

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

  • Café-au-lait macules with pulmonary stenosis
  • Congenital absence of abdominal muscle
  • Congenital peripheral pulmonary artery stenosis
  • Congenital retinal aneurysm
  • Congenital stenosis of left pulmonary artery
  • Congenital stenosis of pulmonary artery
  • Congenital stenosis of pulmonary artery
  • Congenital stenosis of right pulmonary artery
  • Congenital supravalvular pulmonary stenosis
  • Congenital supravalvular pulmonary stenosis
  • Congenital vascular anomaly of eye
  • Peripheral pulmonary artery stenosis
  • Prune belly syndrome
  • Prune belly syndrome with pulmonic stenosis, intellectual disability and deafness
  • Pulmonary artery stenosis
  • Pulmonary trunk stenosis
  • Pulmonary trunk stenosis
  • Pulmonic stenosis and congenital nephrosis
  • Retinal arterial macroaneurysm with supravalvular pulmonic stenosis
  • Retinal macroaneurysm
  • Stenosis of left pulmonary artery
  • Stenosis of right pulmonary artery
  • Supravalvar pulmonary trunk stenosis
  • Supravalvar pulmonary trunk stenosis

Clinical Classification

Clinical Category:
Cardiac and circulatory congenital anomalies
CCSR Category Code:
MAL001
Inpatient Default CCSR:
Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
Outpatient Default CCSR:
Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Clinical Information

  • Prune Belly Syndrome - a syndrome characterized by abdominal wall musculature deficiency, cryptorchism, and urinary tract abnormalities. the syndrome derives its name from its characteristic distended abdomen with wrinkled skin.
  • Branch Pulmonary Artery Stenosis|Pulmonary Artery Stenosis, Branch (not PPS) - narrowing of the lumen of the right or left pulmonary artery branch.
  • Congenital Pulmonary Artery Stenosis - a congenital cardiovascular abnormality characterized by the narrowing of the lumen of the main pulmonary artery or its branches. it may be associated with other congenital heart malformations. signs and symptoms include dyspnea, tachypnea, tachycardia, fatigue, and edema.
  • Physiologic Pulmonary Artery Stenosis Murmur|Physiologic pulmonary artery stenosis - an innocent murmur with a medium or high pitched, blowing character heard at the left middle sternal border that can also be heard at the same volume across the precordium and back that does not disappear with maneuvers but is only heard in infants less than six months of age. (acc/aha)
  • Pulmonary Artery Stenosis - a congenital or acquired cardiovascular abnormality characterized by the narrowing of the lumen of the main pulmonary artery or its branches. signs and symptoms include dyspnea, tachypnea, tachycardia, fatigue, and edema.
  • Supravalvular Pulmonary Artery Stenosis|Pulmonary Artery Stenosis, Supravalvar - stenosis of the pulmonary artery that occurs above the valve.

Tabular List of Diseases and Injuries

The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.


Inclusion Terms

Inclusion Terms
These 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.
  • Supravalvular pulmonary stenosis

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

Present on Admission (POA)

Q25.6 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 IndicatorReason 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 Q25.6 to ICD-9-CM

  • ICD-9-CM Code: 747.39 - Oth anom pul artery/circ
    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
  • 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. This was the first year ICD-10-CM was implemented into the HIPAA code set.

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.