Is Q45.3 a billable ICD-10-CM code?

Yes. Q45.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Q45.3 sit in the tabular list?

Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Other congenital malformations of the digestive system (Q38-Q45).

What cannot be coded together with Q45.3?

Q45.3 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

Q45.3

Q45.3 — Other congenital malformations of pancreas and pancreatic duct

Billable / specific codeICD-10-CMPOA exempt

Q45.3 is a billable, specific ICD-10-CM code for other congenital malformations of pancreas and pancreatic duct. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

congenital diabetes mellitus (E10.-)
cystic fibrosis (E84.0-E84.9)
fibrocystic disease of pancreas (E84.-)
neonatal diabetes mellitus (P70.2)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Accessory pancreas
Congenital malformation of pancreas or pancreatic duct NOS

Risk adjustment

Q45.3 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

Q45.3 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56421Billing and Coding: CT of the Abdomen and Pelvis
A58833Enteral Nutrition - Policy Article

How Q45.3 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to Q45.3.

Aberrant›pancreas
Accessory›pancreas
Anomaly, anomalous›pancreas or pancreatic duct
Deformity›pancreas(congenital)
Distortion›pancreas
Duplication, duplex›pancreas
Ectopic, ectopia›pancreas
Hypertrophy, hypertrophic›pancreas, congenital
Malposition›congenital›pancreas

Related codes at this level

Codes that share Q45. If Q45.3 is not quite right, the correct code is usually one of these.

Questions about Q45.3

Is Q45.3 a billable ICD-10-CM code?: Yes. Q45.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Q45.3 sit in the tabular list?: Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Other congenital malformations of the digestive system (Q38-Q45).
What cannot be coded together with Q45.3?: Q45.3 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.