Q25.5

Billable

Atresia of pulmonary artery

HCC Category Mapping

RxHCCHCC 191 — Congenital Heart/Circulatory Disorders and Fontan Circulation

0.000

What This Code Means

A congenital condition where the pulmonary artery (vessel carrying blood to the lungs) is completely closed or absent, preventing normal blood flow to the lungs.

Coding Tips

•This is a critical congenital heart defect requiring early intervention; verify surgical or interventional management
•Often associated with other heart defects; document any concurrent conditions

Clinical Significance

Pulmonary artery atresia is a critical congenital heart defect requiring immediate neonatal intervention and lifelong cardiac management. This condition represents one of the most severe forms of congenital heart disease with significant impact on survival and quality of life.

Documentation Requirements

✓Echocardiographic confirmation of absent or closed pulmonary artery
✓Assessment of associated cardiac anomalies
✓Documentation of cyanosis and oxygen saturation levels
✓Cardiac catheterization findings if performed
✓Surgical intervention plans and procedures
✓Assessment of collateral circulation to lungs
✓Multi-stage surgical planning documentation
✓Long-term cardiology follow-up requirements

Commonly Confused Codes

Q25.1 — Coarctation of aorta (aortic narrowing, not pulmonary)Q22.0 — Pulmonary valve atresia (valve problem, not arterial atresia)Q25.71 — Coarctation of pulmonary artery (narrowing, not complete closure)Q25.79 — Other congenital malformations of pulmonary artery (less specific)