2020 ICD-10-CM Diagnosis Code Q21.1

Atrial septal defect

    2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
  • Q21.1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • The 2020 edition of ICD-10-CM Q21.1 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of Q21.1 - other international versions of ICD-10 Q21.1 may differ.
Applicable To
  • Coronary sinus defect
  • Patent or persistent foramen ovale
  • Patent or persistent ostium secundum defect (type II)
  • Patent or persistent sinus venosus defect
The following code(s) above Q21.1 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to Q21.1:
  • Q00-Q99
    2020 ICD-10-CM Range Q00-Q99

    Congenital malformations, deformations and chromosomal abnormalities

    Note
    • Codes from this chapter are not for use on maternal records
    Type 2 Excludes
    • inborn errors of metabolism (E70-E88)
    Congenital malformations, deformations and chromosomal abnormalities
  • Q21
    ICD-10-CM Diagnosis Code Q21

    Congenital malformations of cardiac septa

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Type 1 Excludes
    • acquired cardiac septal defect (I51.0)
    Congenital malformations of cardiac septa
Approximate Synonyms
  • Atrial septal defect through coronary sinus orifice
  • Atrial septal defect, coronary sinus type
  • Atrial septal defect, ostium secundum type
  • Atrial septal defect, sinus venosus
  • Common atrium
  • Cor triloculare biventriculare
  • Ostium secundum type atrial septal defect
  • Patent foramen ovale
  • Sinus venosus atrial septal defect
Clinical Information
  • A condition in which the foramen ovale in the atrial septum fails to close shortly after birth. This results in abnormal communications between the two upper chambers of the heart. An isolated patent ovale foramen without other structural heart defects is usually of no hemodynamic significance.
  • Defect in the wall between the lower chambers of the heart
  • Developmental abnormalities in any portion of the atrial septum resulting in abnormal communications between the two upper chambers of the heart. Classification of atrial septal defects is based on location of the communication and types of incomplete fusion of atrial septa with the endocardial cushions in the fetal heart. They include ostium primum, ostium secundum, sinus venosus, and coronary sinus defects.
  • The presence of a defect (opening) in the septum that separates the two atria of the heart. The asd can be congenital or acquired.
Present On Admission
POA Help
"Present On Admission" is defined as present at the time the order for inpatient admission occurs — conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery, are considered POA.
  • Q21.1 is considered exempt from POA reporting.
ICD-10-CM Q21.1 is grouped within Diagnostic Related Group(s) (MS-DRG v37.0):
  • 306 Cardiac congenital and valvular disorders with mcc
  • 307 Cardiac congenital and valvular disorders without mcc

Convert Q21.1 to ICD-9-CM

Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change
Code annotations containing back-references to Q21.1:
  • Code Also: I27.83
    ICD-10-CM Diagnosis Code I27.83

    Eisenmenger's syndrome

      2018 - New Code 2019 2020 Billable/Specific Code
    Applicable To
    • Eisenmenger's complex
    • (Irreversible) Eisenmenger's disease
    • Pulmonary hypertension with right to left shunt related to congenital heart disease
    Code Also
    • underlying heart defect, if known, such as:
    • atrial septal defect (Q21.1)
    • Eisenmenger's defect (Q21.8)
    • patent ductus arteriosus (Q25.0)
    • ventricular septal defect (Q21.0)

Diagnosis Index entries containing back-references to Q21.1:
  • Abnormal, abnormality, abnormalities - see also Anomaly
    • sinus venosus Q21.1
  • Absence (of) (organ or part) (complete or partial)
    • septum
      • atrial Q21.1 (congenital)
    • atrial septum Q21.1 (congenital)
  • Acleistocardia Q21.1
  • Agenesis
  • Anomaly, anomalous (congenital) (unspecified type) Q89.9
    ICD-10-CM Diagnosis Code Q89.9

    Congenital malformation, unspecified

      2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
    Applicable To
    • Congenital anomaly NOS
    • Congenital deformity NOS
    • atrial
      • septa Q21.1
    • foramen
      • Botalli Q21.1
      • ovale Q21.1
    • heart Q24.9
      ICD-10-CM Diagnosis Code Q24.9

      Congenital malformation of heart, unspecified

        2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
      Applicable To
      • Congenital anomaly of heart
      • Congenital disease of heart
      • septum Q21.9
        ICD-10-CM Diagnosis Code Q21.9

        Congenital malformation of cardiac septum, unspecified

          2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
        Applicable To
        • Septal (heart) defect NOS
        • auricular Q21.1
        • interatrial Q21.1
  • Closure
    • foramen ovale, imperfect Q21.1
    • interauricular septum, defective Q21.1
  • Common
    • atrium Q21.1
  • Cor
    • triloculare Q20.8
      ICD-10-CM Diagnosis Code Q20.8

      Other congenital malformations of cardiac chambers and connections

        2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
      Applicable To
      • Cor binoculare
      • biventriculare Q21.1
  • Cyanosis R23.0
    ICD-10-CM Diagnosis Code R23.0

    Cyanosis

      2016 2017 2018 2019 2020 Billable/Specific Code
    Type 1 Excludes
    • acrocyanosis (I73.8)
    • cyanotic attacks of newborn (P28.2)
    • due to
      • patent foramen botalli Q21.1
      • persistent foramen ovale Q21.1
  • Defect, defective Q89.9
    ICD-10-CM Diagnosis Code Q89.9

    Congenital malformation, unspecified

      2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
    Applicable To
    • Congenital anomaly NOS
    • Congenital deformity NOS
    • atrial septal (ostium secundum type) Q21.1
    • ostium
      • secundum Q21.1
    • septal (heart) Q21.9
      ICD-10-CM Diagnosis Code Q21.9

      Congenital malformation of cardiac septum, unspecified

        2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
      Applicable To
      • Septal (heart) defect NOS
    • auricular septal Q21.1
    • coronary sinus Q21.1
    • interatrial septal Q21.1
    • interauricular septal Q21.1
    • sinus venosus Q21.1
  • Deformity Q89.9
    ICD-10-CM Diagnosis Code Q89.9

    Congenital malformation, unspecified

      2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
    Applicable To
    • Congenital anomaly NOS
    • Congenital deformity NOS
    • heart (congenital) Q24.9
      ICD-10-CM Diagnosis Code Q24.9

      Congenital malformation of heart, unspecified

        2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
      Applicable To
      • Congenital anomaly of heart
      • Congenital disease of heart
      • septum Q21.9
        ICD-10-CM Diagnosis Code Q21.9

        Congenital malformation of cardiac septum, unspecified

          2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
        Applicable To
        • Septal (heart) defect NOS
        • auricular Q21.1
    • atrial septal Q21.1
  • Disease, diseased - see also Syndrome
    • Lutembacher's Q21.1 (atrial septal defect with mitral stenosis)
  • Foramen ovale Q21.1 (nonclosure) (patent) (persistent)
  • Fusion, fused (congenital)
    • atria Q21.1
    • auricles, heart Q21.1
  • Imperfect
    • closure (congenital)
      • foramen
        • botalli Q21.1
        • ovale Q21.1
      • ostium
        • interatrial Q21.1
        • interauricular Q21.1
      • septum
        • atrial Q21.1 (secundum)
        • interatrial Q21.1 (secundum)
        • interauricular Q21.1 (secundum)
      • atrium Q21.1 (secundum)
      • interatrial ostium or septum Q21.1
      • interauricular ostium or septum Q21.1
  • Lutembacher's disease or syndrome Q21.1 (atrial septal defect with mitral stenosis)
  • Nonclosure - see also Imperfect, closure
  • Ostium
    • secundum Q21.1 (arteriosum) (defect) (patent) (persistent)
  • Patent - see also Imperfect, closure
    • foramen
      • botalli Q21.1
      • ovale Q21.1
    • interauricular septum Q21.1
    • ostium secundum Q21.1
  • Perforation, perforated (nontraumatic) (of)
    • atrial septum, multiple Q21.1
  • Persistence, persistent (congenital)
  • Syndrome - see also Disease
    • Lutembacher's Q21.1

ICD-10-CM Codes Adjacent To Q21.1
Q20.1 Double outlet right ventricle
Q20.2 Double outlet left ventricle
Q20.3 Discordant ventriculoarterial connection
Q20.4 Double inlet ventricle
Q20.5 Discordant atrioventricular connection
Q20.6 Isomerism of atrial appendages
Q20.8 Other congenital malformations of cardiac chambers and connections
Q20.9 Congenital malformation of cardiac chambers and connections, unspecified
Q21 Congenital malformations of cardiac septa
Q21.0 Ventricular septal defect
Q21.1 Atrial septal defect
Q21.2 Atrioventricular septal defect
Q21.3 Tetralogy of Fallot
Q21.4 Aortopulmonary septal defect
Q21.8 Other congenital malformations of cardiac septa
Q21.9 Congenital malformation of cardiac septum, unspecified
Q22 Congenital malformations of pulmonary and tricuspid valves
Q22.0 Pulmonary valve atresia
Q22.1 Congenital pulmonary valve stenosis
Q22.2 Congenital pulmonary valve insufficiency
Q22.3 Other congenital malformations of pulmonary valve

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.