Q40.9 — Congenital malformation of upper alimentary tract, unspecified
Q40.9 is a billable, specific ICD-10-CM code for congenital malformation of upper alimentary tract, unspecified. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Congenital anomaly of upper alimentary tract
- Congenital deformity of upper alimentary tract
Risk adjustment
Q40.9 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
Q40.9 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
How Q40.9 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 Q40.9.
- Anomaly, anomalous›alimentary tract›upper
- Anomaly, anomalous›digestive organ or tract›upper
- Deformity›alimentary tract, congenital›upper
- Malformation›alimentary tract›upper
Related codes at this level
Codes that share Q40. If Q40.9 is not quite right, the correct code is usually one of these.
Questions about Q40.9
- Is Q40.9 a billable ICD-10-CM code?
- Yes. Q40.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Q40.9 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).