Q45.3

Q45.3: Other congenital malformations of pancreas and pancreatic duct

Billable / specific codeICD-10-CMPOA exempt

Q45.3 is a billable, specific ICD-10-CM code for other congenital malformations of pancreas and pancreatic duct. It is valid for submission on a claim.

Check Q45.3 with the rest of the claim: free scrubber

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

congenital diabetes mellitus (E10.-)
cystic fibrosis (E84.0-E84.9)
fibrocystic disease of pancreas (E84.-)
neonatal diabetes mellitus (P70.2)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Accessory pancreas
Congenital malformation of pancreas or pancreatic duct NOS

Excludes2 inherited from the categories above Q45.3

Not part of this code, but both may be coded when both are present.

Written on Q45: Other congenital malformations of digestive system

congenital diaphragmatic hernia (Q79.0)
congenital hiatus hernia (Q40.1)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

Q45.3 is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56421Billing and Coding: CT of the Abdomen and Pelvis
A58833Enteral Nutrition - Policy Article

Alphabetic index entries that lead here

Aberrant›pancreas
Accessory›pancreas
Anomaly, anomalous›pancreas or pancreatic duct
Deformity›pancreas(congenital)
Distortion›pancreas
Duplication, duplex›pancreas
Ectopic, ectopia›pancreas
Hypertrophy, hypertrophic›pancreas, congenital
Malposition›congenital›pancreas

Code history

Unchanged in every release from FY2024 to FY2027.