ICD-10 Q24.6
Billable / Specific MCCCongenital heart block
About ICD-10-CM Q24.6
ICD-10-CM code Q24.6 represents Congenital heart block. This is a billable/specific code in the Congenital Malformations chapter (block Q24). The 2026 edition of ICD-10-CM Q24.6 became effective on October 1, 2025.
Coding Tips for Q24.6
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
Q24.6 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inpatient DRG Impact, MCC
codes Congenital heart block. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for Q24.6
Local Coverage Determinations (LCDs) from CMS MACs that list Q24.6 as a covered diagnosis.
Showing top 10 of 287 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Q24.6.
1 Aetna
5 Medicare
CPT Codes Commonly Billed with Q24.6
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 33208 CMS LCD: Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers � Coding and Billing CMS LCD
- 33206 CMS LCD: Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers � Coding and Billing CMS LCD
- 33207 CMS LCD: Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers � Coding and Billing CMS LCD
- 0573T CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
- 0574T CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
- 0614T CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
- 0577T CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
- 0572T CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
- 0576T CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
- 0575T CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
Convert Q24.6 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 |
|---|---|---|
| Q24.6 | 74686 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To Q24.6
Other codes in section Q20-Q28 (Congenital malformations of the circulatory system).
ICD-10 Q24.6, Billing FAQ
Is ICD-10 code Q24.6 billable? +
Yes, Q24.6 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is Q24.6 a CC or MCC for inpatient DRG? +
Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with Q24.6? +
Procedures frequently paired with Q24.6 include: 33208, 33206, 33207, 0573T, 0574T.
What ICD-9 codes does Q24.6 map to? +
Per CMS GEMs, Q24.6 maps to ICD-9 codes: 74686. 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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