Is Q43 a billable ICD-10-CM code?

No. Q43 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does Q43 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).

Q43

Q43 — Other congenital malformations of intestine

Non-billable headerICD-10-CM

Q43 is a non-billable header ICD-10-CM code for other congenital malformations of intestine. It cannot be billed on its own: choose one of the more specific child codes below.

Other codes that can never be billed with Q43

These codes carry an Excludes1 note pointing at Q43. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Q43 alone.

P76.1Transitory ileus of newborn
Q52.2Congenital rectovaginal fistula
C17.3Meckel's diverticulum, malignant
K57Diverticular disease of intestine
K59.3Megacolon, not elsewhere classified
K60.3Anal fistula
K60.4Rectal fistula
K60.5Anorectal fistula

Risk adjustment

Q43 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 Q43

10 child codes. Green means billable.

Questions about Q43

Is Q43 a billable ICD-10-CM code?: No. Q43 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does Q43 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).