ICD-10-CM Code Q21.3
Tetralogy of Fallot
Billable CodeBillable codes are sufficient justification for admission to an acute care hospital when used a principal diagnosis.
POA Exempt CodeThe Center for Medicare & Medicaid Services (CMS) requires medical coders to indicate whether or not a condition was present at the time of admission, in order to properly assign MS-DRG codes. This "Present On Admission" (POA) indicator is recorded on CMS form 4010A.
Q21.3 is a billable ICD code used to specify a diagnosis of tetralogy of Fallot. A 'billable code' is detailed enough to be used to specify a medical diagnosis.
POA Indicators on CMS form 4010A are as follows:
|Indicator||Meaning||CMS Will Pay CC/MCC DRG Costs|
|Y||Diagnosis was present at time of inpatient admission||Yes|
|N||Diagnosis was not present at time of inpatient admission||No|
|U||Documentation insufficient to determine if the condition was present at the time of inpatient admission.||No|
|W||Clinically undetermined. Provider unable to clinically determine whether the condition was present at the time of inpatient admission.||Yes|
|1||Exempt from POA reporting||No|
The ICD code Q213 is used to code Tetralogy of Fallot
Tetralogy of Fallot (TOF) is a congenital heart defect which is classically understood to involve four anatomical abnormalities of the heart (although only three of them are always present). It is the most common cyanotic heart defect and the most common cause of blue baby syndrome. TOF is usually a right-to-left shunt, in which higher resistance to right ventricular outflow results in more severe cyanosis symptoms.
|Specialty:||Cardiac Surgery, Pediatrics|
|ICD 9 Code:||745.2|
Diagram of a healthy heart and one with tetralogy of Fallot
Coding Notes for Q21.3 Info for medical coders on how to properly use this ICD-10 code
Inclusion TermsInclusion Terms are a list of concepts for which a specific code is used. The list of Inclusion Terms is useful for determining the correct code in some cases, but the list is not necessarily exhaustive.
- Ventricular septal defect with pulmonary stenosis or atresia, dextroposition of aorta and hypertrophy of right ventricle.
- DRG Group #306-307 - Cardiac congenital and valvular disorders with MCC.
- DRG Group #306-307 - Cardiac congenital and valvular disorders without MCC.
Related Concepts SNOMET-CT
- Dextraposition of aorta in Fallot's tetralogy (disorder)
- Tetralogy of Fallot with absent pulmonary valve (disorder)
ICD-10-CM Alphabetical Index References for 'Q21.3 - Tetralogy of Fallot'
The ICD-10-CM Alphabetical Index links the below-listed medical terms to the ICD code Q21.3. Click on any term below to browse the alphabetical index.
Equivalent ICD-9 Code GENERAL EQUIVALENCE MAPPINGS (GEM)
This is the official exact match mapping between ICD9 and ICD10, as provided by the General Equivalency mapping crosswalk. This means that in all cases where the ICD9 code 745.2 was previously used, Q21.3 is the appropriate modern ICD10 code.