Q23.4

Q23.4: Hypoplastic left heart syndrome

Billable / specific codeICD-10-CMPOA exemptleft

Q23.4 is a billable, specific ICD-10-CM code for hypoplastic left heart syndrome. It is valid for submission on a claim.

Check Q23.4 with the rest of the claim: free scrubber

Other codes that can never be billed with Q23.4

Their own Excludes1 notes name this code, so the conflict is not listed above.

Q23.0Congenital stenosis of aortic valve
Q25.4Other congenital malformations of aorta

Risk adjustment

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

Medicare coverage

Q23.4 is named in 17 Medicare coverage policies: 17 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
A52868Billing and Coding: Transesophageal Echocardiography (TEE)
A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
A56451Billing and Coding: Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)

Alphabetic index entries that lead here

Hypoplasia, hypoplastic›left heart syndrome
Syndrome›hypoplastic left-heart
Atresia, atretic›aortic›congenital with hypoplasia of ascending aorta and defective development of left ventricle(with mitral stenosis)
Atresia, atretic›aortic›in hypoplastic left heart syndrome
Atresia, atretic›mitral valve›in hypoplastic left heart syndrome
Hypoplasia, hypoplastic›aorta, aortic›ascending, in hypoplastic left heart syndrome
Development›defective, congenital›left ventricle›in hypoplastic left heart syndrome
Hypoplasia, hypoplastic›aorta, aortic›valve›in hypoplastic left heart syndrome

Code history

Unchanged in every release from FY2024 to FY2027.