ICD-10-CM Code For Other Congenital Malformations Of Upper Alimentary Tract: Group Overview

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group Q40 includes congenital anomalies of the upper alimentary tract such as malformations of the mouth, tongue, pharynx, and upper esophagus that can impair feeding and swallowing. These ICD-10-CM diagnosis codes are used to document specific anatomic defects, associated functional impairment, and any related complications or severity of the condition. Accurate coding within the ICD-10-CM Q40 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

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ICD-10-CM Q40: Other Congenital Malformations Of Upper Alimentary Tract Overview

This group comprises congenital malformations affecting the upper portions of the alimentary tract, including anatomical anomalies of the mouth, tongue, pharynx, and upper esophagus. These conditions target structures involved in feeding, swallowing, and early digestion, and may impact growth, nutrition, and airway safety. Accurate coding is important for complete clinical documentation and supports appropriate reimbursement for services related to diagnosis and management.

When to Use

Use a code from this group when a patient has a documented congenital anomaly of the upper alimentary tract confirmed by clinical examination or diagnostic testing. Select the most specific code that describes the anatomic site and any associated functional impairment or complications.

ICD-10-CM Codes

6 rows

ICD-10-CM Code	Description
Q40.0	Congenital hypertrophic pyloric stenosis
Q40.1	Congenital hiatus hernia
Q40.2	Other specified congenital malformations of stomach
Q40.3	Congenital malformation of stomach, unspecified
Q40.8	Other specified congenital malformations of upper alimentary tract
Q40.9	Congenital malformation of upper alimentary tract, unspecified

DRG Codes

3 rows

DRG Code	Description
393	Other Digestive System Diagnoses with MCC
394	Other Digestive System Diagnoses with CC
395	Other Digestive System Diagnoses without CC/MCC

Typical Clinical Scenarios

A full-term newborn is evaluated soon after birth for drooling, coughing with feeds, and inability to pass an orogastric tube; contrast study and endoscopy confirm a congenital esophageal web causing partial obstruction of the upper esophagus. The infant is admitted for feeding support and surgical planning; a diagnosis from this group is assigned to capture the structural congenital anomaly of the upper alimentary tract causing neonatal feeding and airway-risk symptoms. Typical codes: Q40.0, Q40.2
An adult patient with a history of dysphagia since childhood presents to the outpatient clinic with progressive solids-only difficulty and recurrent food impaction; barium swallow and endoscopy reveal a congenital esophageal membrane (web) previously undiagnosed. Because the presentation reflects a lifelong congenital malformation contributing to chronic swallowing impairment and need for dilation therapy, a code from this group is used to document the underlying congenital lesion. Typical codes: Q40.1, Q40.3
A pediatric patient with a known congenital cleft palate and associated upper alimentary tract malformation is brought in for preoperative assessment after repeated aspiration pneumonias and failure to thrive. The congenital malformation of the upper digestive tract is coded as a comorbid condition contributing to feeding dysfunction and respiratory complications during surgical planning and hospitalization. Typical codes: Q40.8, Q40.9

ICD-10-CM Code For Other Congenital Malformations Of Tongue Mouth And Pharynx: Group Overview

Q39-CONGENITAL-MALFORMATIONS-OF-ESOPHAGUS

ICD-10-CM Code For Congenital Malformations Of Esophagus: Group Overview

Q41-CONGENITAL-ABSENCE-ATRESIA-STENOSIS-SMALL-INTESTINE

ICD-10-CM Code For Congenital Absence, Atresia And Stenosis Of Small Intestine: Group Overview

Q42-CONGENITAL-LARGE-INTESTINE-MALFORMATIONS

ICD-10-CM Code For Congenital Absence, Atresia And Stenosis Of Large Intestine: Group Overview

Q43-OTHER-CONGENITAL-MALFORMATIONS-OF-INTESTINE

ICD-10-CM Code For Other Congenital Malformations Of Intestine: Group Overview

Q44-CONGENITAL-MALFORMATIONS-OF-GALLBLADDER

ICD-10-CM Code For Congenital Malformations Of Gallbladder, Bile Ducts And Liver: Group Overview

Q45-OTHER-CONGENITAL-MALFORMATIONS-DIGESTIVE

ICD-10-CM Code For Other Congenital Malformations Of Digestive System: Group Overview

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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When to Use

ICD-10-CM Codes

6 rows

ICD-10-CM Code	Description
Q40.0	Congenital hypertrophic pyloric stenosis
Q40.1	Congenital hiatus hernia
Q40.2	Other specified congenital malformations of stomach
Q40.3	Congenital malformation of stomach, unspecified
Q40.8	Other specified congenital malformations of upper alimentary tract
Q40.9	Congenital malformation of upper alimentary tract, unspecified

DRG Codes

3 rows

DRG Code	Description
393	Other Digestive System Diagnoses with MCC
394	Other Digestive System Diagnoses with CC
395	Other Digestive System Diagnoses without CC/MCC

Typical Clinical Scenarios

A full-term newborn is evaluated soon after birth for drooling, coughing with feeds, and inability to pass an orogastric tube; contrast study and endoscopy confirm a congenital esophageal web causing partial obstruction of the upper esophagus. The infant is admitted for feeding support and surgical planning; a diagnosis from this group is assigned to capture the structural congenital anomaly of the upper alimentary tract causing neonatal feeding and airway-risk symptoms. Typical codes: Q40.0, Q40.2
An adult patient with a history of dysphagia since childhood presents to the outpatient clinic with progressive solids-only difficulty and recurrent food impaction; barium swallow and endoscopy reveal a congenital esophageal membrane (web) previously undiagnosed. Because the presentation reflects a lifelong congenital malformation contributing to chronic swallowing impairment and need for dilation therapy, a code from this group is used to document the underlying congenital lesion. Typical codes: Q40.1, Q40.3
A pediatric patient with a known congenital cleft palate and associated upper alimentary tract malformation is brought in for preoperative assessment after repeated aspiration pneumonias and failure to thrive. The congenital malformation of the upper digestive tract is coded as a comorbid condition contributing to feeding dysfunction and respiratory complications during surgical planning and hospitalization. Typical codes: Q40.8, Q40.9

ICD-10-CM Code For Other Congenital Malformations Of Tongue Mouth And Pharynx: Group Overview

Q39-CONGENITAL-MALFORMATIONS-OF-ESOPHAGUS

ICD-10-CM Code For Congenital Malformations Of Esophagus: Group Overview

Q41-CONGENITAL-ABSENCE-ATRESIA-STENOSIS-SMALL-INTESTINE

ICD-10-CM Code For Congenital Absence, Atresia And Stenosis Of Small Intestine: Group Overview

Q42-CONGENITAL-LARGE-INTESTINE-MALFORMATIONS

ICD-10-CM Code For Congenital Absence, Atresia And Stenosis Of Large Intestine: Group Overview

Q43-OTHER-CONGENITAL-MALFORMATIONS-OF-INTESTINE

ICD-10-CM Code For Other Congenital Malformations Of Intestine: Group Overview

Q44-CONGENITAL-MALFORMATIONS-OF-GALLBLADDER

ICD-10-CM Code For Congenital Malformations Of Gallbladder, Bile Ducts And Liver: Group Overview

Q45-OTHER-CONGENITAL-MALFORMATIONS-DIGESTIVE

ICD-10-CM Code For Other Congenital Malformations Of Digestive System: Group Overview

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

ICD-10-CM Code For Other Congenital Malformations Of Upper Alimentary Tract: Group Overview

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ICD-10-CM Q40: Other Congenital Malformations Of Upper Alimentary Tract Overview

ICD-10-CM Code For Other Congenital Malformations Of Upper Alimentary Tract: Group Overview

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ICD-10-CM Q40: Other Congenital Malformations Of Upper Alimentary Tract Overview

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

References

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

References

ICD-10-CM Code For Other Congenital Malformations Of Upper Alimentary Tract: Group Overview

Sign up for ICD-10-CM Code For Other Congenital Malformations Of Upper Alimentary Tract: Group Overview policy alerts

ICD-10-CM Q40: Other Congenital Malformations Of Upper Alimentary Tract Overview

ICD-10-CM Code For Other Congenital Malformations Of Upper Alimentary Tract: Group Overview

Sign up for ICD-10-CM Code For Other Congenital Malformations Of Upper Alimentary Tract: Group Overview policy alerts

ICD-10-CM Q40: Other Congenital Malformations Of Upper Alimentary Tract Overview

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which anatomical areas are covered by ICD-10-CM code group `Q40`?

What specific diagnosis codes are included in the `Q40` group?

Why is accurate coding within `Q40` important for clinical documentation and billing?

Which DRGs are commonly related to diagnoses in the `Q40` group?

What clinical impacts are associated with congenital malformations in the `Q40` group?

References

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which anatomical areas are covered by ICD-10-CM code group `Q40`?

What specific diagnosis codes are included in the `Q40` group?

Why is accurate coding within `Q40` important for clinical documentation and billing?

Which DRGs are commonly related to diagnoses in the `Q40` group?

What clinical impacts are associated with congenital malformations in the `Q40` group?

References