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Q22.5

Billable

Ebstein's anomaly

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

What This Code Means

A birth defect where the tricuspid valve is displaced downward into the right ventricle, causing the valve to function abnormally and allowing blood to leak backward.

Coding Tips

  • This is a named condition; ensure the diagnosis specifically states Ebstein's anomaly rather than using a more general tricuspid valve code
  • Often associated with atrial septal defects and arrhythmias; review for additional diagnoses

Code Hierarchy

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