ICD-10 · PDGM grouping
Q42 Congenital absence, atresia and stenosis of large intestine
All 6 codes in the Q42 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
6
Cannot lead a claim
0
What CMS assigns to Q42
All 6 codes group to MMTA - Other. None of the 6 is assigned a comorbidity subgroup. Every code can lead a claim.
Every code in Q42
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 |
|---|---|---|---|---|
| Q42.0 | Congenital absence, atresia and stenosis of rectum with fistulaCMS: Congenital absence, atresia and stenosis of rectum w fistula | Can lead a claim | A | None |
| Q42.1 | Congenital absence, atresia and stenosis of rectum without fistulaCMS: Congen absence, atresia and stenosis of rectum w/o fistula | Can lead a claim | A | None |
| Q42.2 | Congenital absence, atresia and stenosis of anus with fistulaCMS: Congenital absence, atresia and stenosis of anus w fistula | Can lead a claim | A | None |
| Q42.3 | Congenital absence, atresia and stenosis of anus without fistulaCMS: Congenital absence, atresia and stenosis of anus w/o fistula | Can lead a claim | A | None |
| Q42.8 | Congenital absence, atresia and stenosis of other parts of large intestineCMS: Congenital absence, atresia and stenosis of prt lg int | Can lead a claim | A | None |
| Q42.9 | Congenital absence, atresia and stenosis of large intestine, part unspecifiedCMS: Congen absence, atresia and stenosis of lg int, part unsp | Can lead a claim | A | 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.
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