Q22.8 ICD-10-CM Code: Other congenital malformations of tricuspid valve
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)
Q22.8
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther congenital malformations of tricuspid valve
A birth defect affecting the tricuspid valve (the valve between the right chambers of the heart) with specific structural abnormalities other than the more common types.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
MappedHCC 137
Varies by metal level
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for Q22.8 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for Q22.8 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Q22.8 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for Q22.8 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Q22.8 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Q22.8 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Q22.8 in this effective period.
Buddy Documentation Tip
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 →
Is Q22.8 an HCC code?
No. Q22.8 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- Q22.8
- Description
- Other congenital malformations of tricuspid valve
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Q22.8 is the ICD-10-CM diagnosis code for other congenital malformations of tricuspid valve. A birth defect affecting the tricuspid valve (the valve between the right chambers of the heart) with specific structural abnormalities other than the more common types. Q22.8 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).
Q22.8 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Use this code only when the tricuspid valve malformation is documented as a specific type not captured by Q22.0-Q22.7.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Q22.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when the tricuspid valve malformation is documented as a specific type not captured by Q22.0-Q22.7
- •Ensure documentation specifies the exact nature of the malformation to support medical necessity