ICD-10-CM Code Q43.1
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.
Q43.1 is a billable ICD code used to specify a diagnosis of hirschsprung's disease. 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 Q431 is used to code Hirschsprung's disease
Hirschsprung's disease or Hirschsprung disease (HD), also called congenital megacolon or congenital aganglionic megacolon, is a form of megacolon that occurs when part or all of the large intestine or antecedent parts of the gastrointestinal tract have no ganglion cells and therefore cannot function. During normal prenatal development, cells from the neural crest migrate into the large intestine (colon) to form the networks of nerves called the myenteric plexus (Auerbach plexus) (between the smooth muscle layers of the gastrointestinal tract wall) and the submucosal plexus (Meissner plexus) (within the submucosa of the gastrointestinal tract wall). In Hirschsprung's disease, the migration is not complete and part of the colon lacks these nerve bodies that regulate the activity of the colon. The affected segment of the colon cannot relax and pass stool through the colon, creating an obstruction. In most affected people, the disorder affects the part of the colon that is nearest the anus. In rare cases, the lack of nerve bodies involves more of the colon. In five percent of cases, the entire colon is affected. Stomach and esophagus may be affected too.
|ICD 9 Code:||751.3|
Histopathology of Hirschsprung disease. Enzyme histochemistry showing aberrant acetylcholine esterase (AchE)-positive nerve fibers (brown) in the lamina propria mucosae.
Coding Notes for Q43.1 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.
- Congenital (aganglionic) megacolon
- DRG Group #393-395 - Other digestive system diagnoses with MCC.
- DRG Group #393-395 - Other digestive system diagnoses with CC.
- DRG Group #393-395 - Other digestive system diagnoses without CC or MCC.
Related Concepts SNOMET-CT
- Hirschsprung's disease (disorder)
- Aganglionosis of Auerbach's plexus (disorder)
- Secondary megacolon - congenital (disorder)
ICD-10-CM Alphabetical Index References for 'Q43.1 - Hirschsprung's disease'
The ICD-10-CM Alphabetical Index links the below-listed medical terms to the ICD code Q43.1. Click on any term below to browse the alphabetical index.
Equivalent ICD-9 Code GENERAL EQUIVALENCE MAPPINGS (GEM)
This is the official approximate match mapping between ICD9 and ICD10, as provided by the General Equivalency mapping crosswalk. This means that while there is no exact mapping between this ICD10 code Q43.1 and a single ICD9 code, 751.3 is an approximate match for comparison and conversion purposes.