Skip to main content

Q21.1 vs Q21.20

Q21.1 (Atrial septal defect) compared with Q21.20 (Atrioventricular septal defect, unspecified as to partial or complete), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).

Can these codes be reported together?

Yes, when both are documented. Q21.1 carries an Excludes2 note covering Q21.20: “ostium primum atrial septal defect (type I) (Q21.20)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

Q21.1Atrial septal defectQ21.20Atrioventricular septal defect, unspecified as to partial or complete
Billing statusNon-billable header

Report instead: Q21.10, Q21.11, Q21.12, Q21.13, Q21.14

Billable
ClassificationQ00-Q99 — Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99)Q00-Q99 — Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99)
DefinitionAtrial septal defect is a non-billable ICD-10-CM category code (Q21.1).Atrioventricular septal defect, unspecified as to partial or complete is a billable ICD-10-CM diagnosis code (Q21.20).
Includes
Atrioventricular canal, NOS
Endocardial cushion defect NOS
Ostium primum atrial septal defect (type I) NOS

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources