ICD-10 · PDGM grouping
Q40 Other congenital malformations of upper alimentary tract
All 6 codes in the Q40 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
6
Can lead a claim
4
Cannot lead a claim
2
What CMS assigns to Q40
4 of the 6 codes group to MMTA - Other; 2 are assigned no clinical group. None of the 6 is assigned a comorbidity subgroup. 4 of the 6 can lead a claim.
Every code in Q40
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| Q40.0 | Congenital hypertrophic pyloric stenosis | Can lead a claim | A | None |
| Q40.1 | Congenital hiatus hernia | Can lead a claim | A | None |
| Q40.2 | Other specified congenital malformations of stomach | Can lead a claim | A | None |
| Q40.3 | Congenital malformation of stomach, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Q40.8 | Other specified congenital malformations of upper alimentary tractCMS: Oth congenital malformations of upper alimentary tract | Can lead a claim | A | None |
| Q40.9 | Congenital malformation of upper alimentary tract, unspecifiedCMS: Congenital malformation of upper alimentary tract, unsp | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
The monthly home health regs digest
What CMS changed, what's due next, and what to do about it — one email a month, no fluff. Read the first issue