2027 ICD-10-CM Diagnosis Code Q44.3Congenital stenosis and stricture of bile ducts
ICD-10-CM Codes›Q00-Q99›Q38-Q45›Q44
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Risk Adjusts — HCC 68
- POA Exempt
- Chronic Condition
Q44.3 is a billable ICD-10-CM diagnosis code for congenital stenosis and stricture of bile ducts. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 444 through 446. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 4 closely related codes. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Digestive congenital anomalies.
For Medicare Advantage risk adjustment, Q44.3 maps to CMS-HCC Category 68 (Cholangitis and Obstruction of Bile Duct Without Gallstones) under the V28 model, adding a risk factor of about 0.388 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Present on Admission (POA)Billing
Q44.3 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Other congenital malformations of the digestive system (Q38-Q45).
Medicare Risk Adjustment (HCC)Billing
Q44.3 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Arthrogryposis with renal dysfunction and cholestasis syndrome
- Biliary stricture
- Cholestasis in newborn
- Congenital developmental anomaly of cystic duct
- Congenital kink of cystic duct
- Congenital obstruction of bile duct
- Congenital stricture of bile duct
- Congenital stricture of common bile duct
- Inherited disorder of bilirubin metabolism
- Neonatal jaundice due to congenital obstruction of bile duct
- Neurogenic arthrogryposis multiplex congenita
- Stenosis of bile duct
- Stenosis of cystic duct
- Stricture of bile duct
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Q44.3: its own notes plus those printed at Chapter 17. A note printed at a category, block or chapter applies to every code under it.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Notes
General instructions on how these codes are used.
- Codes from this chapter are not for use on maternal records
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name Q44.3, its category, or a range that includes it.
Excludes1 2
These codes carry an Excludes1 note naming Q44.3: they are not reported together with it, unless the two conditions are unrelated.
- K83.1 Obstruction of bile ductcongenital obstruction of bile duct (Q44.3)
- Block P50-P61 Hemorrhagic and hematological disorders of newborncongenital stenosis and stricture of bile ducts (Q44.3)
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Stenosis, stenotic (cicatricial) See Also: Stricture;
Stricture See Also: Stenosis;
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Bile Duct Diseases
Your liver makes a digestive juice called bile. Your gallbladder stores it between meals. When you eat, your gallbladder pushes the bile into tubes called bile ducts. They carry the bile to your small intestine. The bile helps break down fat. It also helps the liver get rid of toxins and wastes.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Q44.3 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Q44.3Overview
What is the ICD-10 code for congenital stenosis and stricture of bile ducts?
The ICD-10-CM code for congenital stenosis and stricture of bile ducts is Q44.3 (sometimes written as Q443). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Q44.3 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report congenital stenosis and stricture of bile ducts on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Q44.3 group to?
When congenital stenosis and stricture of bile ducts is the principal diagnosis on an inpatient stay, it groups to MS-DRG 444, 445, 446, with relative weights from 0.8121 to 1.6662 depending on complications. Higher weights mean higher Medicare reimbursement.
Is Q44.3 a CC or MCC?
CMS lists Q44.3 as an MCC (major complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 4 closely related codes in its exclusion list.
Is Q44.3 exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for congenital stenosis and stricture of bile ducts on inpatient claims. The code appears in the Other congenital malformations of the digestive system (Q38-Q45) range of the CMS exempt list.
What HCC is Q44.3?
Q44.3 (congenital stenosis and stricture of bile ducts) maps to CMS-HCC Category 68 (Cholangitis and Obstruction of Bile Duct Without Gallstones), commonly written as HCC 68, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It does not map to any RxHCC in the Part D prescription drug model.
Does Q44.3 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, Q44.3 adds a risk adjustment factor of about 0.388 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.085 to 0.391 depending on the payment segment). A more severe related category (HCC 62, HCC 63, and HCC 64) supersedes it when both are reported. See the full factor table on the HCC 68 category page.
