ICD-10 · PDGM grouping
Q38-Q45 — Other congenital malformations of the digestive system
Every ICD-10-CM code in this range and the PDGM clinical group CMS assigns to it, read from the CMS grouper crosswalk v07.2.26.
ICD-10-CM FY2027 · CMS grouper v07.2.26
Codes in range
61
No clinical group
5
A period cannot be grouped from these.
Barred as primary
0
CMS rejects these in the primary position.
Where these codes group
56 of the 61 codes in Q38-Q45 group to MMTA - Other. A further 5 are assigned no clinical group at all, which means a 30-day period cannot be grouped from them.
Code families in Q38-Q45
One page per three-character family: every code in it, whether it can lead a claim, its clinical group and comorbidity subgroup.
- Q38Other congenital malformations of tongue, mouth and pharynx9 codes
- Q39Congenital malformations of esophagus9 codes
- Q40Other congenital malformations of upper alimentary tract6 codes
- Q41Congenital absence, atresia and stenosis of small intestine5 codes
- Q42Congenital absence, atresia and stenosis of large intestine6 codes
- Q43Other congenital malformations of intestine10 codes
- Q44Congenital malformations of gallbladder, bile ducts and liver10 codes
- Q45Other congenital malformations of digestive system6 codes
Every code in Q38-Q45
Descriptions are CMS’s own, abbreviated as CMS abbreviates them.
| Code | Description | Clinical group | Primary position |
|---|---|---|---|
| Q380 | Congenital malformations of lips, not elsewhere classified | A | Can lead a claim |
| Q381 | Ankyloglossia | A | Can lead a claim |
| Q382 | Macroglossia | A | Can lead a claim |
| Q383 | Other congenital malformations of tongue | A | Can lead a claim |
| Q384 | Congenital malformations of salivary glands and ducts | A | Can lead a claim |
| Q385 | Congenital malformations of palate, not elsewhere classified | A | Can lead a claim |
| Q386 | Other congenital malformations of mouth | A | Can lead a claim |
| Q387 | Congenital pharyngeal pouch | A | Can lead a claim |
| Q388 | Other congenital malformations of pharynx | A | Can lead a claim |
| Q390 | Atresia of esophagus without fistula | A | Can lead a claim |
| Q391 | Atresia of esophagus with tracheo-esophageal fistula | A | Can lead a claim |
| Q392 | Congenital tracheo-esophageal fistula without atresia | A | Can lead a claim |
| Q393 | Congenital stenosis and stricture of esophagus | A | Can lead a claim |
| Q394 | Esophageal web | A | Can lead a claim |
| Q395 | Congenital dilatation of esophagus | A | Can lead a claim |
| Q396 | Congenital diverticulum of esophagus | A | Can lead a claim |
| Q398 | Other congenital malformations of esophagus | A | Can lead a claim |
| Q399 | Congenital malformation of esophagus, unspecified | None | Cannot lead a claim |
| Q400 | Congenital hypertrophic pyloric stenosis | A | Can lead a claim |
| Q401 | Congenital hiatus hernia | A | Can lead a claim |
| Q402 | Other specified congenital malformations of stomach | A | Can lead a claim |
| Q403 | Congenital malformation of stomach, unspecified | None | Cannot lead a claim |
| Q408 | Oth congenital malformations of upper alimentary tract | A | Can lead a claim |
| Q409 | Congenital malformation of upper alimentary tract, unsp | None | Cannot lead a claim |
| Q410 | Congenital absence, atresia and stenosis of duodenum | A | Can lead a claim |
| Q411 | Congenital absence, atresia and stenosis of jejunum | A | Can lead a claim |
| Q412 | Congenital absence, atresia and stenosis of ileum | A | Can lead a claim |
| Q418 | Congenital absence, atresia and stenosis of prt sm int | A | Can lead a claim |
| Q419 | Congen absence, atresia and stenosis of sm int, part unsp | A | Can lead a claim |
| Q420 | Congenital absence, atresia and stenosis of rectum w fistula | A | Can lead a claim |
| Q421 | Congen absence, atresia and stenosis of rectum w/o fistula | A | Can lead a claim |
| Q422 | Congenital absence, atresia and stenosis of anus w fistula | A | Can lead a claim |
| Q423 | Congenital absence, atresia and stenosis of anus w/o fistula | A | Can lead a claim |
| Q428 | Congenital absence, atresia and stenosis of prt lg int | A | Can lead a claim |
| Q429 | Congen absence, atresia and stenosis of lg int, part unsp | A | Can lead a claim |
| Q430 | Meckel's diverticulum (displaced) (hypertrophic) | A | Can lead a claim |
| Q431 | Hirschsprung's disease | A | Can lead a claim |
| Q432 | Other congenital functional disorders of colon | A | Can lead a claim |
| Q433 | Congenital malformations of intestinal fixation | A | Can lead a claim |
| Q434 | Duplication of intestine | A | Can lead a claim |
| Q435 | Ectopic anus | A | Can lead a claim |
| Q436 | Congenital fistula of rectum and anus | A | Can lead a claim |
| Q437 | Persistent cloaca | A | Can lead a claim |
| Q438 | Other specified congenital malformations of intestine | A | Can lead a claim |
| Q439 | Congenital malformation of intestine, unspecified | None | Cannot lead a claim |
| Q440 | Agenesis, aplasia and hypoplasia of gallbladder | A | Can lead a claim |
| Q441 | Other congenital malformations of gallbladder | A | Can lead a claim |
| Q442 | Atresia of bile ducts | A | Can lead a claim |
| Q443 | Congenital stenosis and stricture of bile ducts | A | Can lead a claim |
| Q444 | Choledochal cyst | A | Can lead a claim |
| Q445 | Other congenital malformations of bile ducts | A | Can lead a claim |
| Q446 | Cystic disease of liver | A | Can lead a claim |
| Q4470 | Other congenital malformation of liver, unspecified | A | Can lead a claim |
| Q4471 | Alagille syndrome | A | Can lead a claim |
| Q4479 | Other congenital malformations of liver | A | Can lead a claim |
| Q450 | Agenesis, aplasia and hypoplasia of pancreas | A | Can lead a claim |
| Q451 | Annular pancreas | A | Can lead a claim |
| Q452 | Congenital pancreatic cyst | A | Can lead a claim |
| Q453 | Oth congenital malformations of pancreas and pancreatic duct | A | Can lead a claim |
| Q458 | Other specified congenital malformations of digestive system | A | Can lead a claim |
| Q459 | Congenital malformation of digestive system, unspecified | None | Cannot lead a claim |
Source: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01. 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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