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

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group Q43 includes congenital malformations of the intestine such as intestinal atresia, stenosis, duplications, and other developmental anomalies affecting intestinal structure and function. These ICD-10-CM diagnosis codes are used to document patients with congenital intestinal defects, capturing anatomic location, presence of obstruction or perforation, and associated clinical complexity. Accurate coding within the ICD-10-CM Q43 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

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ICD-10-CM Q43: Other Congenital Malformations Of Intestine Overview

This group includes congenital structural anomalies of the intestine present at birth that affect intestinal form and function. It targets congenital malformations of the digestive system, specifically intestinal atresia, stenosis, and other developmental anomalies. Accurate coding matters for clinical records, appropriate classification of congenital conditions, and reimbursement support tied to documented complexity.

When to Use

Use a code from this group when documenting a congenital intestinal malformation identified clinically, radiographically, or surgically in a patient. Select the most specific code that indicates the type and location of the intestinal anomaly and any associated complications.

ICD-10-CM Codes

10 rows

ICD-10-CM Code	Description
Q43.0	Meckel's diverticulum (displaced) (hypertrophic)
Q43.1	Hirschsprung's disease
Q43.2	Other congenital functional disorders of colon
Q43.3	Congenital malformations of intestinal fixation
Q43.4	Duplication of intestine
Q43.5	Ectopic anus
Q43.6	Congenital fistula of rectum and anus
Q43.7	Persistent cloaca
Q43.8	Other specified congenital malformations of intestine
Q43.9	Congenital malformation of intestine, unspecified

DRG Codes

6 rows

DRG Code	Description
380	Complicated Peptic Ulcer with MCC
381	Complicated Peptic Ulcer with CC
382	Complicated Peptic Ulcer without CC/MCC
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 neonate presents in the first days of life with bilious vomiting, abdominal distension, and failure to pass meconium; abdominal radiographs suggest distal intestinal obstruction and contrast enema indicates colonic atresia. The infant undergoes surgical exploration confirming an atretic segment of the colon requiring resection and primary anastomosis; a congenital malformation of the intestine is assigned to capture the anatomical defect. Typical codes: Q43.2, Q43.3
A young child has chronic intermittent abdominal pain, poor weight gain, and episodes of constipation since infancy; imaging and endoscopic evaluation identify congenital malrotation with associated nonobstructive intrinsic narrowing of a segment of small intestine causing dysmotility symptoms. The chronic structural anomaly of the intestine is coded to reflect the congenital cause of the ongoing digestive symptoms and growth issues. Typical codes: Q43.1, Q43.4
An adult with a history of repaired congenital intestinal atresia in childhood presents with acute small bowel obstruction from adhesive stricturing at the surgical anastomosis, with nausea, vomiting, and obstipation requiring admission and possible surgical intervention. The encounter documents a complication related to a prior congenital intestinal malformation and its repair, so a code for the congenital malformation of the intestine is used alongside acute management codes. Typical codes: Q43.5, Q43.9}

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

Q40-OTHER-CONGENITAL-MALFORMATIONS-UPPER-ALIMENTARY-TRACT

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

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

10 rows

ICD-10-CM Code	Description
Q43.0	Meckel's diverticulum (displaced) (hypertrophic)
Q43.1	Hirschsprung's disease
Q43.2	Other congenital functional disorders of colon
Q43.3	Congenital malformations of intestinal fixation
Q43.4	Duplication of intestine
Q43.5	Ectopic anus
Q43.6	Congenital fistula of rectum and anus
Q43.7	Persistent cloaca
Q43.8	Other specified congenital malformations of intestine
Q43.9	Congenital malformation of intestine, unspecified

DRG Codes

6 rows

DRG Code	Description
380	Complicated Peptic Ulcer with MCC
381	Complicated Peptic Ulcer with CC
382	Complicated Peptic Ulcer without CC/MCC
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 neonate presents in the first days of life with bilious vomiting, abdominal distension, and failure to pass meconium; abdominal radiographs suggest distal intestinal obstruction and contrast enema indicates colonic atresia. The infant undergoes surgical exploration confirming an atretic segment of the colon requiring resection and primary anastomosis; a congenital malformation of the intestine is assigned to capture the anatomical defect. Typical codes: Q43.2, Q43.3
A young child has chronic intermittent abdominal pain, poor weight gain, and episodes of constipation since infancy; imaging and endoscopic evaluation identify congenital malrotation with associated nonobstructive intrinsic narrowing of a segment of small intestine causing dysmotility symptoms. The chronic structural anomaly of the intestine is coded to reflect the congenital cause of the ongoing digestive symptoms and growth issues. Typical codes: Q43.1, Q43.4
An adult with a history of repaired congenital intestinal atresia in childhood presents with acute small bowel obstruction from adhesive stricturing at the surgical anastomosis, with nausea, vomiting, and obstipation requiring admission and possible surgical intervention. The encounter documents a complication related to a prior congenital intestinal malformation and its repair, so a code for the congenital malformation of the intestine is used alongside acute management codes. Typical codes: Q43.5, Q43.9}

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

Q40-OTHER-CONGENITAL-MALFORMATIONS-UPPER-ALIMENTARY-TRACT

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

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.

Published by

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 Intestine: Group Overview

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

ICD-10-CM Q43: Other Congenital Malformations Of Intestine Overview

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

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

ICD-10-CM Q43: Other Congenital Malformations Of Intestine 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 Intestine: Group Overview

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

ICD-10-CM Q43: Other Congenital Malformations Of Intestine Overview

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

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

ICD-10-CM Q43: Other Congenital Malformations Of Intestine Overview

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which conditions are included in the ICD-10-CM Q43 group?

How should coders capture clinical detail within the `Q43` group for billing and reimbursement?

What specific ICD-10-CM codes are listed under the Q43 group?

How does accurate coding in the `Q43` group affect claims and clinical records?

Which DRGs are related to diagnoses in the Q43 group for payment grouping?

References

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which conditions are included in the ICD-10-CM Q43 group?

How should coders capture clinical detail within the `Q43` group for billing and reimbursement?

What specific ICD-10-CM codes are listed under the Q43 group?

How does accurate coding in the `Q43` group affect claims and clinical records?

Which DRGs are related to diagnoses in the Q43 group for payment grouping?

References