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Q40.1

Billable

Congenital hiatus hernia

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

A birth defect where part of the stomach protrudes through an opening in the diaphragm into the chest cavity, which may cause reflux or breathing difficulties.

Coding Tips

  • •Specify whether the hernia is sliding or paraesophageal if documented
  • •Document any associated symptoms such as reflux, respiratory distress, or feeding difficulties

Excludes 1 — Do NOT code together

  • congenital diaphragmatic hernia (Q79.0)

Code Hierarchy

└Q40Other congenital malformations of upper alimentary tract└Q40.1Congenital hiatus hernia
└Q40.1Congenital hiatus hernia

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