Q25.0

Billable

Patent ductus arteriosus

HCC Category Mapping

RxHCCHCC 191 — Congenital Heart/Circulatory Disorders and Fontan Circulation

0.000

What This Code Means

A congenital heart condition where the ductus arteriosus, a blood vessel that normally closes after birth, remains open and allows blood to bypass the lungs.

Coding Tips

•This is a common congenital heart defect in premature infants; document whether it's being managed medically or requires surgical closure
•Specify if associated with other cardiac anomalies, as PDA often coexists with other congenital heart conditions

Clinical Significance

Patent ductus arteriosus represents a common congenital heart defect that can lead to heart failure, pulmonary hypertension, and other cardiovascular complications if left untreated. The condition requires careful monitoring and often intervention to prevent long-term cardiac and pulmonary complications.

Documentation Requirements

✓Echocardiographic confirmation of persistent ductal patency
✓Documentation of left-to-right shunting
✓Assessment of ductal size and hemodynamic significance
✓Clinical symptoms related to the PDA
✓Gestational age at birth and current age
✓Associated congenital anomalies if present
✓Treatment plan (medical vs surgical intervention)
✓Follow-up cardiology recommendations

Commonly Confused Codes

Q25.1 — Coarctation of aorta (narrowing of aortic arch, not ductal patency)I25.41 — Coronary artery aneurysm (acquired coronary condition in adults)Q21.0 — Ventricular septal defect (hole between ventricles, not ductal)Q25.3 — Supravalvular aortic stenosis (aortic outflow obstruction)

Code Hierarchy

└Q25Congenital malformations of great arteries └Q25.0Patent ductus arteriosus

└Q25.0Patent ductus arteriosus