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Q21.12

Billable

Patent foramen ovale

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

A small opening in the wall between the two upper chambers of the heart that normally closes after birth but remains open, allowing a small amount of blood to pass through.

Coding Tips

  • •Patent foramen ovale (PFO) is extremely common and often clinically insignificant; code only when documented as a diagnosis
  • •Document whether the PFO is associated with symptoms or other cardiac conditions that warrant treatment

Code Hierarchy

└Q21Congenital malformations of cardiac septa└Q21.1Atrial septal defect└Q21.12Patent foramen ovale
└Q21.12Patent foramen ovale

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