ICD-10 Q21.2
Non-Billable HeaderAtrioventricular septal defect
About ICD-10-CM Q21.2
ICD-10-CM code Q21.2 represents Atrioventricular septal defect. This is a non-billable header code in the Congenital Malformations chapter (block Q21). The 2026 edition of ICD-10-CM Q21.2 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under Q21.2. Per CMS ICD-10-CM Tabular 2026.
- Atrioventricular canal defect
- Endocardial cushion defect
- Ostium primum atrial septal defect (type I)
Medicare LCD Coverage for Q21.2
Local Coverage Determinations (LCDs) from CMS MACs that list Q21.2 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Q21.2.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but Q21.2 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with Q21.2
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert Q21.2 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| Q21.2 | 74560 | 10000 |
| Q21.2 | 74561 | 10000 |
| Q21.2 | 74569 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To Q21.2
Other codes in section Q20-Q28 (Congenital malformations of the circulatory system).
ICD-10 Q21.2, Billing FAQ
Is ICD-10 code Q21.2 billable? +
No, Q21.2 is a non-billable header code. Use a more specific child code from block Q21 when submitting claims.
What other names or terms map to Q21.2? +
ICD-10 Q21.2 includes: Atrioventricular canal defect; Endocardial cushion defect; Ostium primum atrial septal defect (type I).
What ICD-9 codes does Q21.2 map to? +
Per CMS GEMs, Q21.2 maps to ICD-9 codes: 74560, 74561, 74569. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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