Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.31
    OpenPayerBilling CodesCongenital malformations and deformations of the musculoskeletal systemICD-10-CM q79-congenital-musculoskeletal-malformations
    Ask Trek AI about this page

    ICD-10-CM Code For Congenital Malformations Of Musculoskeletal System, Not Elsewhere Classified: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group Q79 includes congenital malformations of the musculoskeletal system not classified elsewhere, such as various limb, skeletal, and muscular developmental anomalies present at birth. These ICD-10-CM diagnosis codes are used to document congenital structural abnormalities, capture the extent of anatomical involvement, and indicate associated functional impairment or clinical complexity. Accurate coding within the ICD-10-CM Q79 group supports proper claim adjudication and complete clinical documentation and appropriate reimbursement.

    Customize your policy alerts

    Sign up for ICD-10-CM Code For Congenital Malformations Of Musculoskeletal System, Not Elsewhere Classified: Group Overview policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    ICD-10-CM Q79: Congenital Malformations Of Musculoskeletal System, Not Elsewhere Classified Overview

    This group represents congenital malformations affecting bones, joints, muscles, and connective tissues that are not classified in other specific ICD-10-CM categories. It targets structural and developmental anomalies of the musculoskeletal system present at birth. Accurate coding is important to reflect clinical complexity and to support appropriate reimbursement and longitudinal care planning.

    Table of contents

    Progress1 / 6

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    When to Use

    Use a code from this group when documenting a congenital musculoskeletal structural anomaly that does not have a more specific ICD-10-CM category. Select codes to reflect the specific anatomical site, laterality, and any associated functional impairment when documented in the medical record.

    ICD-10-CM Codes

    14 rows

    ICD-10-CM CodeDescription
    Q79.0Congenital diaphragmatic hernia
    Q79.1Other congenital malformations of diaphragm
    Q79.2Exomphalos
    Q79.3Gastroschisis
    Q79.4Prune belly syndrome
    Q79.51Congenital hernia of bladder
    Q79.59Other congenital malformations of abdominal wall
    Q79.60Ehlers-Danlos syndrome, unspecified
    Q79.61Classical Ehlers-Danlos syndrome
    Q79.62Hypermobile Ehlers-Danlos syndrome
    Q79.63Vascular Ehlers-Danlos syndrome
    Q79.69Other Ehlers-Danlos syndromes
    Q79.8Other congenital malformations of musculoskeletal system
    Q79.9Congenital malformation of musculoskeletal system, unspecified

    DRG Codes

    10 rows

    DRG CodeDescription
    205Other Respiratory System Diagnoses with MCC
    206Other Respiratory System Diagnoses without MCC
    393Other Digestive System Diagnoses with MCC
    394Other Digestive System Diagnoses with CC
    395Other Digestive System Diagnoses without CC/MCC
    564Other Musculoskeletal System and Connective Tissue Diagnoses with MCC
    565Other Musculoskeletal System and Connective Tissue Diagnoses with CC
    566Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCC
    791Prematurity with Major Problems
    793Full Term Neonate with Major Problems

    Typical Clinical Scenarios

    • A newborn infant is noted at birth to have a shortened, hypoplastic right upper limb with absent forearm bones on newborn exam and radiographs confirming limb reduction defect. The infant is evaluated by neonatology and orthopedics for limb-length discrepancy and prosthetic/rehabilitation planning; a congenital malformation diagnosis from this group is assigned to document the congenital absence or reduction of limb structures. Typical codes: Q79.1, Q79.2
    • An adult with long-standing right clubfoot and rigid foot deformity presents to orthopedics for progressive pain and difficulty with ambulation; prior childhood treatment included casting but residual cavovarus and limited ankle motion persist. Imaging and physical exam confirm congenital talipes equinovarus as the underlying structural deformity contributing to current disability, so a congenital musculoskeletal malformation code is used as a primary diagnosis alongside any secondary osteoarthritic changes. Typical codes: Q79.51, Q79.59
    • A pediatric patient with known congenital scoliosis from vertebral segmentation anomalies is admitted after worsening respiratory compromise and progressive spinal curvature; multidisciplinary care is required to manage pulmonary restriction and plan surgical fusion. The congenital origin of the spinal deformity is coded to explain the structural cause of the respiratory and orthopedic complications. Typical codes: Q79.3, Q79.8

    Related Codes

    Q65-CONGENITAL-DEFORMITIES-OF-HIP

    ICD-10-CM Code For Congenital Deformities Of Hip: Group Overview

    Q66-CONGENITAL-DEFORMITIES-OF-FEET

    ICD-10-CM Code For Congenital Deformities Of Feet: Group Overview

    Q67-CONGENITAL-MUSCULOSKELETAL-DEFORMITIES-HEAD-FACE-SPINE-CHEST

    ICD-10-CM Code For Congenital Musculoskeletal Deformities Of Head Face Spine And Chest: Group Overview

    Q68-OTHER-CONGENITAL-MUSCULOSKELETAL-DEFORMITIES

    ICD-10-CM Code For Other Congenital Musculoskeletal Deformities: Group Overview

    Q69-POLYDACTYLY

    ICD-10-CM Code For Polydactyly: Group Overview

    Q70-SYNDACTYLY-CONGENITAL-DIGIT-FUSION

    ICD-10-CM Code For Syndactyly: Group Overview

    Q71-REDUCTION-DEFECTS-OF-UPPER-LIMB

    ICD-10-CM Code For Reduction Defects Of Upper Limb: Group Overview

    Q72-REDUCTION-DEFECTS-OF-LOWER-LIMB

    ICD-10-CM Code For Reduction Defects Of Lower Limb: Group Overview

    Q73-REDUCTION-DEFECTS-OF-UNSPECIFIED-LIMB

    ICD-10-CM Code For Reduction Defects Of Unspecified Limb: Group Overview

    Q74-OTHER-CONGENITAL-MALFORMATIONS-OF-LIMBS

    ICD-10-CM Code For Other Congenital Malformations Of Limb(S): Group Overview

    Showing 1–10 of 14

    Frequently Asked Questions

    References

    1. 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. 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. 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.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.