Q40.1
Q40.1: Congenital hiatus hernia
Billable / specific codeICD-10-CMPOA exempt
Q40.1 is a billable, specific ICD-10-CM code for congenital hiatus hernia. It is valid for submission on a claim.
Check Q40.1 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- congenital diaphragmatic hernia (Q79.0)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Congenital displacement of cardia through esophageal hiatus
Other codes that can never be billed with Q40.1
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
Q40.1 is named in 4 Medicare coverage policies: 4 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56389Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
- A56781Billing and Coding: Transthoracic Echocardiography (TTE)
- A57063Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
- A57306Billing and Coding: Transthoracic Echocardiography (TTE)
Alphabetic index entries that lead here
- Displacement, displaced›cardia through esophageal hiatus(congenital)
- Hernia, hernial›hiatal›congenital
- Hernia, hernial›paraesophageal›congenital
Code history
Unchanged in every release from FY2024 to FY2027.