ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 Q89.89

Billable / Specific CC

Other specified congenital malformations

Q89
Block
0
Synonyms
64
LCDs
7
Payer Policies
0
Linked CPTs

About ICD-10-CM Q89.89

ICD-10-CM code Q89.89 represents Other specified congenital malformations. This is a billable/specific code in the Congenital Malformations chapter (block Q89). The 2026 edition of ICD-10-CM Q89.89 became effective on October 1, 2025.

Coding Tips for Q89.89

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

Q89.89 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inpatient DRG Impact, CC

codes Other specified congenital malformations. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for Q89.89

Local Coverage Determinations (LCDs) from CMS MACs that list Q89.89 as a covered diagnosis.

64 LCDs

Showing top 10 of 64 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Endovenous Stenting
Article ID: 56644, Effective: 2025-10-01 00:00:00, 66 covered, 0 non-covered
CPT 37182 →
CMS LCD: Billing and Coding: Endovenous Stenting
Article ID: 56644, Effective: 2025-10-01 00:00:00, 66 covered, 0 non-covered
CPT 37239 →
CMS LCD: Billing and Coding: Endovenous Stenting
Article ID: 56644, Effective: 2025-10-01 00:00:00, 66 covered, 0 non-covered
CPT 37183 →
CMS LCD: Billing and Coding: Endovenous Stenting
Article ID: 56644, Effective: 2025-10-01 00:00:00, 66 covered, 0 non-covered
CPT 37238 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 56781, Effective: 2025-10-01 00:00:00, 1425 covered, 0 non-covered
CPT 93320 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 56781, Effective: 2025-10-01 00:00:00, 1425 covered, 0 non-covered
CPT 76376 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 56781, Effective: 2025-10-01 00:00:00, 1425 covered, 0 non-covered
CPT J0461 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 56781, Effective: 2025-10-01 00:00:00, 1425 covered, 0 non-covered
CPT 93306 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 56781, Effective: 2025-10-01 00:00:00, 1425 covered, 0 non-covered
CPT 93325 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 56781, Effective: 2025-10-01 00:00:00, 1425 covered, 0 non-covered
CPT J2785 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing Q89.89.

7 policies

1 Cigna

Transthoracic Echocardiography in Adults - (0510)
Policy ID: MM_0510

5 Medicare

Billing and Coding: Endovenous Stenting
Policy ID: ART-56414
Billing and Coding: Endovenous Stenting
Policy ID: ART-56644
Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
Policy ID: ART-56726
Billing and Coding: Heavy Metal Testing
Policy ID: ART-56767
Billing and Coding: Transthoracic Echocardiography (TTE)
Policy ID: ART-56781

CPT Codes Commonly Billed with Q89.89

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for Q89.89

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.

ICD-10 Q89.89, Billing FAQ

Is ICD-10 code Q89.89 billable? +

Yes, Q89.89 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is Q89.89 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

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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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