Q40.3 — Congenital malformation of stomach, unspecified
Q40.3 is a billable, specific ICD-10-CM code for congenital malformation of stomach, unspecified. It is valid for submission on a claim.
Risk adjustment
Q40.3 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
Q40.3 is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56389Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A57063Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
- A57414Billing and Coding: Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)
How Q40.3 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 Q40.3.
- Anomaly, anomalous›pylorus
- Anomaly, anomalous›stomach
- Deformity›pylorus(congenital)
- Deformity›stomach(congenital)
- Malformation›stomach
Related codes at this level
Codes that share Q40. If Q40.3 is not quite right, the correct code is usually one of these.
Questions about Q40.3
- Is Q40.3 a billable ICD-10-CM code?
- Yes. Q40.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Q40.3 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).