Q22.9 ICD-10-CM Code: Congenital malformation of tricuspid valve, unspecified
Q22.9 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools
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FY 2026 Apr update / Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0) / Congenital malformations of the circulatory system (Q20-Q28)
Q22.9
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCongenital malformation of tricuspid valve, unspecified
A birth defect of the tricuspid valve where the specific type or nature of the malformation is not specified or documented.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 137
Code-level coefficient reference
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for Q22.9. Check the code and parent instructions in the Code Book.
Excludes 2
Official- inborn errors of metabolism (E70-E88)Inherited from Q00-QA0
Related Codes
Includes
OfficialNo Includes notes are included in this display for Q22.9. Check the code and parent instructions in the Code Book.
Excludes 1
OfficialNo Excludes 1 notes are included in this display for Q22.9. Check the code and parent instructions in the Code Book.
Code First
OfficialNo Code First sequencing instructions are included in this display for Q22.9. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for Q22.9. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for Q22.9. Check the code and parent instructions in the Code Book.
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 Q22.9 an HCC code?
Q22.9 has no mapping under the current CMS-HCC V28 community payment model. Q22.9 also appears in the HHS-HCC commercial risk model (HCC 137 (HHS-HCC 137 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping.
- Code
- Q22.9
- Description
- Congenital malformation of tricuspid valve, unspecified
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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What This Code Means
Q22.9 is the ICD-10-CM diagnosis code for congenital malformation of tricuspid valve, unspecified. A birth defect of the tricuspid valve where the specific type or nature of the malformation is not specified or documented. Q22.9 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).
Q22.9 has no mapping under the current CMS-HCC V28 community payment model. Q22.9 also appears in the HHS-HCC commercial risk model (HCC 137 (HHS-HCC 137 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.
This is an unspecified code; use only when the specific type of tricuspid valve malformation cannot be determined from documentation.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for Q22.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is an unspecified code; use only when the specific type of tricuspid valve malformation cannot be determined from documentation
- •Query the provider if more specific information about the valve defect is available in the medical record