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

Q21 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software

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Code lookupQ21

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

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Inclusion Terms

Official

No inclusion terms are included in this display for Q21. Check the code and parent instructions in the Code Book.

Excludes 2

Official
  • inborn errors of metabolism (E70-E88)Inherited from Q00-QA0

Includes

Official

No Includes notes are included in this display for Q21. Check the code and parent instructions in the Code Book.

Excludes 1

Official
  • acquired cardiac septal defect (I51.0)

Code First

Official

No Code First sequencing instructions are included in this display for Q21. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for Q21. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for Q21. Check the code and parent instructions in the Code Book.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Code
Q21
Description
Congenital malformations of cardiac septa
HCC (V28)
No CMS-HCC V28 mapping
RAF reference coefficient
Billable
No
Payment year
2026

Coder workflow notes

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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. Coders should select the billable child code that matches the documented presentation and then verify its current source-backed HCC mapping. Do not infer a child code or risk adjustment value from the header alone.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, 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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