Q43.2 — Other congenital functional disorders of colon
Q43.2 is a billable, specific ICD-10-CM code for other congenital functional disorders of colon. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Congenital dilatation of colon
Risk adjustment
Q43.2 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 78 Intestinal Obstruction/Perforation0.326 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
Q43.2 is named in 3 Medicare coverage policies — 3 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
- A56632Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
How Q43.2 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 Q43.2.
- Macrosigmoid›congenital
- Megasigmoid›congenital
- Hypertrophy, hypertrophic›colon›congenital
- Disease, diseased›colon›functional›congenital
Related codes at this level
Codes that share Q43. If Q43.2 is not quite right, the correct code is usually one of these.
- Q43.0Meckel's diverticulum (displaced) (hypertrophic)
- Q43.1Hirschsprung's disease
- Q43.3Congenital malformations of intestinal fixation
- Q43.4Duplication of intestine
- Q43.5Ectopic anus
- Q43.6Congenital fistula of rectum and anus
- Q43.7Persistent cloaca
- Q43.8Other specified congenital malformations of intestine
- Q43.9Congenital malformation of intestine, unspecified
Questions about Q43.2
- Is Q43.2 a billable ICD-10-CM code?
- Yes. Q43.2 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Q43.2 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).