ICD-10 · PDGM grouping
Q43 Other congenital malformations of intestine
All 10 codes in the Q43 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
10
Can lead a claim
9
Cannot lead a claim
1
What CMS assigns to Q43
9 of the 10 codes group to MMTA - Other; 1 is assigned no clinical group. None of the 10 is assigned a comorbidity subgroup. 9 of the 10 can lead a claim.
Every code in Q43
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 |
|---|---|---|---|---|
| Q43.0 | Meckel's diverticulum (displaced) (hypertrophic) | Can lead a claim | A | None |
| Q43.1 | Hirschsprung's disease | Can lead a claim | A | None |
| Q43.2 | Other congenital functional disorders of colon | Can lead a claim | A | None |
| Q43.3 | Congenital malformations of intestinal fixation | Can lead a claim | A | None |
| Q43.4 | Duplication of intestine | Can lead a claim | A | None |
| Q43.5 | Ectopic anus | Can lead a claim | A | None |
| Q43.6 | Congenital fistula of rectum and anus | Can lead a claim | A | None |
| Q43.7 | Persistent cloaca | Can lead a claim | A | None |
| Q43.8 | Other specified congenital malformations of intestine | Can lead a claim | A | None |
| Q43.9 | Congenital malformation of intestine, unspecified | 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