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Q21 ICD-10-CM Code: Congenital malformations of cardiac septa

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FY 2026 Apr update / Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0) / Congenital malformations of the circulatory system (Q20-Q28)

Q21

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Congenital malformations of cardiac septa

Congenital malformations of cardiac septa

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
Q2Congenital malformations of the circulatory system (Q20-Q28)
Q21Congenital malformations of cardiac septa

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for Q21 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for Q21 in this effective period.

Related Child Codes

Official
Q21.0Ventricular septal defect
Q21.1Atrial septal defect
Q21.2Atrioventricular septal defect
Q21.3Tetralogy of Fallot
Q21.4Aortopulmonary septal defect

Includes

Official

ICD-10-CM does not list Includes notes for Q21 in this effective period.

Excludes 1

Official
  • acquired cardiac septal defect (I51.0)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for Q21 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for Q21 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for Q21 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

Q21 is the ICD-10-CM diagnosis code for congenital malformations of cardiac septa. Q21 sits in the ICD-10-CM chapter for congenital malformations, deformations and chromosomal abnormalities (q00-qa0), within the section covering congenital malformations of the circulatory system (q20-q28).

Header codes like Q21 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at Q21's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Q21 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • acquired cardiac septal defect (I51.0)

Child Codes

Code Hierarchy

Q21Congenital malformations of cardiac septa
Q21Congenital malformations of cardiac septa

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