Is Q40 a billable ICD-10-CM code?

No. Q40 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does Q40 sit in the tabular list?

Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Other congenital malformations of the digestive system (Q38-Q45).

Q40

Q40 — Other congenital malformations of upper alimentary tract

Non-billable headerICD-10-CM

Q40 is a non-billable header ICD-10-CM code for other congenital malformations of upper alimentary tract. It cannot be billed on its own: choose one of the more specific child codes below.

Other codes that can never be billed with Q40

These codes carry an Excludes1 note pointing at Q40. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Q40 alone.

Q79.0Congenital diaphragmatic hernia
K31.1Adult hypertrophic pyloric stenosis
K31.2Hourglass stricture and stenosis of stomach
K31.3Pylorospasm, not elsewhere classified
K31.4Gastric diverticulum
K44Diaphragmatic hernia

Risk adjustment

Q40 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.

Code to one of these instead Q40

6 child codes. Green means billable.

Questions about Q40

Is Q40 a billable ICD-10-CM code?: No. Q40 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does Q40 sit in the tabular list?: Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Other congenital malformations of the digestive system (Q38-Q45).