Q26.6
BillablePortal vein-hepatic artery fistula
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Q26.6 an HCC code?
No. Q26.6 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Q26.6 is the ICD-10-CM diagnosis code for portal vein-hepatic artery fistula. A birth defect where an abnormal connection (fistula) forms between the portal vein and the hepatic artery, allowing blood to bypass normal liver circulation. Q26.6 sits in the ICD-10-CM chapter for congenital malformations, deformations, chromosomal abnormalities, and genetic disorders (q00-qa0), within the section covering congenital malformations of the circulatory system (q20-q28).
Q26.6 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.
This is a rare congenital vascular malformation that may cause hemodynamic changes.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Q26.6 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a rare congenital vascular malformation that may cause hemodynamic changes
- •Document any associated symptoms or complications such as portal hypertension if present