2022 ICD-10-CM Code Q40.1

Congenital hiatus hernia

Version 2021

Valid for Submission

ICD-10:Q40.1
Short Description:Congenital hiatus hernia
Long Description:Congenital hiatus hernia

Code Classification

  • Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
    • Other congenital malformations of the digestive system (Q38-Q45)
      • Other congenital malformations of upper alimentary tract (Q40)

Q40.1 is a billable diagnosis code used to specify a medical diagnosis of congenital hiatus hernia. The code Q40.1 is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.

The ICD-10-CM code Q40.1 might also be used to specify conditions or terms like congenital hiatus hernia, galloway mowat syndrome or steroid-resistant nephrotic syndrome. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code Q40.1:


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.

Type 1 Excludes

Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.

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 Q40.1 are found in the index:

Approximate Synonyms

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

Present on Admission (POA)

Q40.1 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 Q40.1 to ICD-9 Code

Information for Patients


Birth Defects

What are birth defects?

A birth defect is a problem that happens while a baby is developing in the mother's body. Most birth defects happen during the first 3 months of pregnancy. One out of every 33 babies in the United States is born with a birth defect.

A birth defect may affect how the body looks, works, or both. Some birth defects like cleft lip or neural tube defects are structural problems that can be easy to see. Others, like heart disease, are found using special tests. Birth defects can range from mild to severe. How a birth defect affects a child's life depends mostly on which organ or body part is involved and how severe the defect is.

What causes birth defects?

For some birth defects, researchers know the cause. But for many birth defects, the exact cause is unknown. Researchers think that most birth defects are caused by a complex mix of factors, which can include

Who is at risk of having a baby with birth defects?

Certain factors may might increase the chances of having a baby with a birth defect, such as

How are birth defects diagnosed?

Health care providers can diagnose some birth defects during pregnancy, using prenatal testing. That's why it important to get regular prenatal care.

Other birth defects may not be found until after the baby is born. Providers may find them through newborn screening. Some defects, such as club foot, are obvious right away. Other times, the health care provider may not discover a defect until later in life, when the child has symptoms.

What are the treatments for birth defects?

Children with birth defects often need special care and treatments. Because the symptoms and problems caused by birth defects vary, the treatments also vary. Possible treatments may include surgery, medicines, assistive devices, physical therapy, and speech therapy.

Often, children with birth defects need a variety of services and may need to see several specialists. The primary health care provider can coordinate the special care that the child needs.

Can birth defects be prevented?

Not all birth defects can be prevented. But there are things you can do before and during pregnancy to increase your chance of having a healthy baby:

Centers for Disease Control and Prevention


[Learn More in MedlinePlus]

Hiatal Hernia

A hiatal hernia is a condition in which the upper part of your stomach bulges through an opening in your diaphragm. Your diaphragm is the thin muscle that separates your chest from your abdomen. Your diaphragm helps keep acid from coming up into your esophagus. When you have a hiatal hernia, it's easier for the acid to come up. This leaking of acid from your stomach into your esophagus is called GERD (gastroesophageal reflux disease). GERD may cause symptoms such as

Often, the cause of a hiatal hernia is unknown. It may have to do with weakness in the surrounding muscles. Sometimes the cause is an injury or a birth defect. Your risk of getting a hiatal hernia goes up as you age; they are common in people over age 50. You are also at higher risk if you have obesity or smoke.

People usually find out that they have a hiatal hernia when they are getting tests for GERD, heartburn, chest pain, or abdominal pain. The tests may be a chest x-ray, an x-ray with a barium swallow, or an upper endoscopy.

You don't need treatment if your hiatal hernia does not cause any symptoms or problems. If you do have symptoms, some lifestyle changes may help. They include eating small meals, avoiding certain foods, not smoking or drinking alcohol, and losing weight. Your health care provider may recommend antacids or other medicines. If these don't help, you may need surgery.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases


[Learn More in MedlinePlus]

Code History

  • 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 (First year ICD-10-CM implemented into the HIPAA code set)