Q21.1 ICD-10-CM Code: Atrial septal defect
HCC Buddy Code Card
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FY 2026 Apr update / Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0) / Congenital malformations of the circulatory system (Q20-Q28)
Q21.1
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceAtrial septal defect
Atrial septal defect
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for Q21.1 in this effective period.
Excludes 2
Official- ostium primum atrial septal defect (type I) (Q21.20)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Q21.1 in this effective period.
Excludes 1
Official- acquired cardiac septal defect (I51.0)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Q21.1 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Q21.1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Q21.1 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
Q21.1 is the ICD-10-CM diagnosis code for atrial septal defect. Q21.1 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 Q21.1 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 Q21.1'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 Q21.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Excludes 2, Not included here, may code separately
- ostium primum atrial septal defect (type I) (Q21.20)