2026 ICD-10-CM Diagnosis Code Q55.7Congenital vasocutaneous fistula

ICD-10-CM Codes›Q00-Q99›Q50-Q56›Q55

ICD-10-CM Q55.7
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Q55.7 is a billable ICD-10-CM diagnosis code for congenital vasocutaneous fistula. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 729 through 730. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Genitourinary congenital anomalies.

Code Identity

ICD-10-CM Code
Q55.7
Billable Status
Yes — Valid for Submission
Code Describes
Congenital vasocutaneous fistula
Short Description
Congenital vasocutaneous fistula
Same as the full description in the CMS dataset.
Parent Code
Q55
Other congenital malformations of male genital organs

Code Classification

ChapterQ00-Q99Congenital malformations, deformations and chromosomal abnormalities
SectionQ50-Q56Congenital malformations of genital organs
CategoryQ55Other congenital malformations of male genital organs
This CodeQ55.7Congenital vasocutaneous fistula

Present on Admission (POA)Billing

Q55.7 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Fistula(cutaneous)
      • vasocutaneous, congenital

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR MAL003
Genitourinary congenital anomalies
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

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.

The full article covers:

  • What are birth defects?
  • What causes birth defects?
  • Who is at risk of having a baby with birth defects?
  • How are birth defects diagnosed?
  • What are the treatments for birth defects?
  • Can birth defects be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert Q55.7 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
752.89 Genital organ anom NEC
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Q55.7Overview

Is Q55.7 (Other congenital malformations of male genital organs) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report congenital vasocutaneous fistula on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does Q55.7 group to?

When congenital vasocutaneous fistula is the principal diagnosis on an inpatient stay, it groups to MS-DRG 729, 730, with relative weights from 0.6720 to 1.0587 depending on complications. Higher weights mean higher Medicare reimbursement.

Is Q55.7 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 vasocutaneous fistula on inpatient claims.

What is the ICD-9 equivalent of Q55.7?

Under the General Equivalence Mappings, congenital vasocutaneous fistula converts to ICD-9-CM 752.89 (genital organ anom NEC). The mapping is approximate, so confirm the match fits the documentation.

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.