2024 ICD-10-CM Diagnosis Code Q42.3

Congenital absence, atresia and stenosis of anus without fistula

ICD-10-CM:
Q42.3
Short Description:
Congenital absence, atresia and stenosis of anus w/o fistula
Is Billable?
Yes - Valid for Submission
Code Navigator:

Code Classification

  • Congenital malformations, deformations and chromosomal abnormalities
    (Q00-Q99)
    • Other congenital malformations of the digestive system
      (Q38-Q45)
      • Congenital absence, atresia and stenosis of large intestine
        (Q42)

Q42.3 is a billable diagnosis code used to specify a medical diagnosis of congenital absence, atresia and stenosis of anus without fistula. 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:

  • Anal atresia
  • Anal atresia
  • Anal atresia
  • Anal atresia
  • Ankyloblepharon
  • Ankyloblepharon filiforme adnatum
  • Ankyloblepharon filiforme adnatum with imperforate anus syndrome
  • Anorectal agenesis
  • Anorectal stricture
  • Anorectal stricture
  • Anus absent
  • Atresia and stenosis of large intestine, rectum and anal canal
  • Congenital absence of anus
  • Congenital ankyloblepharon
  • Congenital occlusion of anus
  • Congenital stricture of anus
  • Karandikar Maria Kamble syndrome
  • Low anorectal malformation
  • PELVIS syndrome
  • Spondylocostal dysostosis with anal atresia and genitourinary malformation syndrome
  • Stenosis of anal canal
  • Stricture of anal canal
  • Stricture of anus
  • Stricture of anus
  • VACTEL syndrome
  • VACTERL syndrome with hydrocephalus
  • Vertebral abnormalities, anal atresia, cardiac abnormalities, tracheo-esophageal fistula, renal anomalies, limb defects syndrome

Clinical Information

  • Low Anorectal Malformation-. congenital malformations in the anorectal region that include the perineal fistula, anteriorly placed anus, and anorecto-vestibular fistula.

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.
  • Imperforate anus

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)

Q42.3 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 to ICD-9-CM Code

Source ICD-10-CM CodeTarget ICD-9-CM Code
Q42.3751.2 - Atresia large intestine
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


Anal Disorders

The anus is the opening of the rectum through which stool passes out of your body. Problems with the anus are common. They include hemorrhoids, abscesses, fissures (cracks), and cancer.

You may be embarrassed to talk about your anal troubles. But it is important to let your doctor know, especially if you have pain or bleeding. The more details you can give about your problem, the better your doctor will be able to help you. Treatments vary depending on the particular problem.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases


[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.