Q21.3 — Tetralogy of Fallot
Q21.3 is a billable, specific ICD-10-CM code for tetralogy of fallot. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Ventricular septal defect with pulmonary stenosis or atresia, dextroposition of aorta and hypertrophy of right ventricle.
Risk adjustment
Q21.3 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
Q21.3 is named in 28 Medicare coverage policies — 28 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52458Automatic External Defibrillators - Policy Article
- A52458Automatic External Defibrillators - Policy Article
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
How Q21.3 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to Q21.3.
- Tetralogy of Fallot
- Dextraposition, aorta›in tetralogy of Fallot
- Fallot's›tetrad or tetralogy
- Syndrome›Fallot's
- Anomaly, anomalous›heart›tetralogy of Fallot
- Defect, defective›interventricular septal›in tetralogy of Fallot
- Defect, defective›interventricular septal›with dextroposition of aorta, pulmonary stenosis and hypertrophy of right ventricle
- Defect, defective›ventricular septal›in tetralogy of Fallot
- Hypertrophy, hypertrophic›ventricle, ventricular›in tetralogy of Fallot
- Stenosis, stenotic›pulmonary›in tetralogy of Fallot
- Stenosis, stenotic›pulmonary›with ventricular septal defect, transposition of aorta, and hypertrophy of right ventricle
- Anomaly, anomalous›heart›septum›interventricular›with pulmonary stenosis or atresia, dextraposition of aorta and hypertrophy of right ventricle
Related codes at this level
Codes that share Q21. If Q21.3 is not quite right, the correct code is usually one of these.
Questions about Q21.3
- Is Q21.3 a billable ICD-10-CM code?
- Yes. Q21.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Q21.3 sit in the tabular list?
- Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Congenital malformations of the circulatory system (Q20-Q28).