Q21.3

Q21.3: Tetralogy of Fallot

Billable / specific codeICD-10-CMPOA exempt

Q21.3 is a billable, specific ICD-10-CM code for tetralogy of fallot. It is valid for submission on a claim.

Check Q21.3 with the rest of the claim: free scrubber

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.

Excludes1 inherited from the categories above Q21.3

A category’s note binds every code beneath it.

Written on Q21: Congenital malformations of cardiac septa

acquired cardiac septal defect (I51.0)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

Q21.3 is named in 21 Medicare coverage policies: 21 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52458Automatic External Defibrillators - Policy Article
A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
A52868Billing and Coding: Transesophageal Echocardiography (TEE)
A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders

Alphabetic index entries that lead here

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

Code history

Unchanged in every release from FY2024 to FY2027.