ICD-10 Q28
Non-Billable HeaderOther congenital malformations of circulatory system
About ICD-10-CM Q28
ICD-10-CM code Q28 represents Other congenital malformations of circulatory system. This is a non-billable header code in the Congenital Malformations chapter (block Q28). The 2026 edition of ICD-10-CM Q28 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.
Type 1 Excludes
Pure excludes, these codes can never be coded together with Q28. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- congenital aneurysm NOS (Q27.8)
- congenital coronary aneurysm (Q24.5)
- ruptured cerebral arteriovenous malformation (I60.8)
- ruptured malformation of precerebral vessels (I72.0)
Type 2 Excludes
Not included here, the excluded code is not part of Q28, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- congenital peripheral aneurysm (Q27.8)
- congenital pulmonary aneurysm (Q25.79)
- congenital retinal aneurysm (Q14.1)
Medicare LCD Coverage for Q28
Local Coverage Determinations (LCDs) from CMS MACs that list Q28 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 Q28.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but Q28 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with Q28
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.
Codes Adjacent To Q28
Other codes in section Q20-Q28 (Congenital malformations of the circulatory system).
ICD-10 Q28, Billing FAQ
Is ICD-10 code Q28 billable? +
No, Q28 is a non-billable header code. Use a more specific child code from block Q28 when submitting claims.
What codes are Type 1 Excludes for Q28? +
Type 1 Excludes (never code together with Q28): congenital aneurysm NOS (Q27.8); congenital coronary aneurysm (Q24.5); ruptured cerebral arteriovenous malformation (I60.8)
What codes are Type 2 Excludes for Q28? +
Type 2 Excludes (may be coded together when both conditions exist): congenital peripheral aneurysm (Q27.8); congenital pulmonary aneurysm (Q25.79); congenital retinal aneurysm (Q14.1)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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