ICD-10 Q45
Non-Billable HeaderOther congenital malformations of digestive system
About ICD-10-CM Q45
ICD-10-CM code Q45 represents Other congenital malformations of digestive system. This is a non-billable header code in the Congenital Malformations chapter (block Q45). The 2026 edition of ICD-10-CM Q45 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 2 Excludes
Not included here, the excluded code is not part of Q45, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- congenital diaphragmatic hernia (Q79.0)
- congenital hiatus hernia (Q40.1)
Medicare LCD Coverage for Q45
Local Coverage Determinations (LCDs) from CMS MACs that list Q45 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 Q45.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but Q45 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with Q45
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 Q45
Other codes in section Q38-Q45 (Other congenital malformations of the digestive system).
ICD-10 Q45, Billing FAQ
Is ICD-10 code Q45 billable? +
No, Q45 is a non-billable header code. Use a more specific child code from block Q45 when submitting claims.
What codes are Type 2 Excludes for Q45? +
Type 2 Excludes (may be coded together when both conditions exist): congenital diaphragmatic hernia (Q79.0); congenital hiatus hernia (Q40.1)
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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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