ICDcodes.org
FY2027

Q21.12 — Patent foramen ovale

BillableCC

Is Q21.12 billable?

Yes — Q21.12 is billable for FY2027. Q21.12 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Q21.12 may be submitted for encounters from October 1, 2026 through September 30, 2027.

Q21.12 at a glance

CodeQ21.12
DescriptionPatent foramen ovale
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

Which MS-DRGs does Q21.12 group to?

Q21.12 sits in MDC 05 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

  • 306Cardiac Congenital and Valvular Disorders with MCCmedical
  • 307Cardiac Congenital and Valvular Disorders without MCCmedical

As a secondary diagnosis, Q21.12 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.

How is Q21.12 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to Q21.12. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Foramen ovale (nonclosure) (patent) (persistent)
  • Closure › foramen ovale, imperfect
  • Anomaly, anomalous › foramen › Botalli (congenital) (unspecified type)
  • Anomaly, anomalous › foramen › ovale (congenital) (unspecified type)
  • Cyanosis › due to › patent foramen botalli
  • Cyanosis › due to › persistent foramen ovale
  • Nonclosure › foramen › botalli
  • Nonclosure › foramen › ovale
  • Patent › foramen › botalli
  • Patent › foramen › ovale
  • Persistence, persistent › foramen › Botalli (congenital)
  • Persistence, persistent › foramen › ovale (congenital)

Inclusion terms

Alternative wording in documentation that is classified to Q21.12.

  • Persistent foramen ovale

Excludes1 — never code together — inherited from Q21

The conditions below can never be reported together with Q21.12 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • acquired cardiac septal defect (I51.0)

Excludes2 — not included here — inherited from Chapter 17

The conditions below are not part of Q21.12, but a patient may have both at the same time. When documentation supports it, Q21.12 and the excluded code may both be reported.

  • inborn errors of metabolism (E70-E88)

Excludes2 — not included here — inherited from Q21.1

The conditions below are not part of Q21.12, but a patient may have both at the same time. When documentation supports it, Q21.12 and the excluded code may both be reported.

  • ostium primum atrial septal defect (type I) (Q21.20)

How long has Q21.12 existed?

Q21.12 first appears in FY2023.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.

Which conditions are coded to Q21.12?

What other codes are in the Q21.1 family? (7)