FY2024
Effective from
- Inherited rules changed
Patent foramen ovale
Billable diagnosis code
CDC/NCHS · FY2024acquired cardiac septal defect (I51.0)
ostium primum atrial septal defect (type I) (Q21.20)
Coverage depends on the payer, service and applicable policy. A billable code does not guarantee payment.
For US diagnosis claims covered by HIPAA, ICD-10-CM is required from October 1, 2015.
Use the service date for outpatient/professional claims and the discharge date for hospital inpatient claims. Earlier encounters use ICD-9-CM; each individual code must also be valid for the applicable date.
Official coding guidelines → · CMS ↗Grouping depends on the complete encounter and CMS grouper logic.
2026-04-01 – 2026-09-30
CMS · MS-DRG 43.1First observed · 2022-10-01
Latest recorded change · FY2024
Effective from
Patent foramen ovale
Billable diagnosis code
CDC/NCHS · FY2024| All editions | Effective from | Code history |
|---|---|---|
| FY2023 | 2022-10-01 | Added |
| FY2023 · 04-01 | 2023-04-01 | No tabular change |
| FY2024 | 2023-10-01 | Inherited rules changed |
| FY2024 · 04-01 | 2024-04-01 | No tabular change |
| FY2025 | 2024-10-01 | No tabular change |
| FY2025 · 04-01 | 2025-04-01 | No tabular change |
| FY2026 | 2025-10-01 | No tabular change |
| FY2026 · April | 2026-04-01 | No tabular change |
| FY2027 | 2026-10-01 | No tabular change |
Persistent foramen ovale
Codes from this chapter are not for use on maternal records
acquired cardiac septal defect (I51.0)
ostium primum atrial septal defect (type I) (Q21.20)
Historical assignments from the CDC conversion table support data retrieval. They do not authorize substituting a previous code for the current code.
Previous assignment: Q21.1
Other entries in the same category; these are not automatic substitutes.
| Code | Description | Category · further specificity required |
|---|---|---|
| Q21.10 | Atrial septal defect, unspecified | Billable / specific |
| Q21.11 | Secundum atrial septal defect | Billable / specific |
| Q21.13 | Coronary sinus atrial septal defect | Billable / specific |
| Q21.14 | Superior sinus venosus atrial septal defect | Billable / specific |
| Q21.15 | Inferior sinus venosus atrial septal defect | Billable / specific |
| Q21.16 | Sinus venosus atrial septal defect, unspecified | Billable / specific |
| Q21.19 | Other specified atrial septal defect | Billable / specific |
Official titles and instructions are preserved in their source language. Official sources ↗