ICD-10 code for rectum congenital absence

The ICD-10-CM code for rectum congenital absence is Q42.1 (Congenital absence, atresia and stenosis of rectum without fistula). The official index lists 2 more specific codes, so check the documentation for details such as type, cause, site or severity before settling on Q42.1.

Within Q42, choose Q42.1 (rectum without fistula) only when documentation doesn't support a more specific option: rectum with fistula (Q42.0), anus with fistula (Q42.2), anus without fistula (Q42.3), other parts of large intestine (Q42.8) and part unspecified (Q42.9).

As a secondary diagnosis it is a CC (complication or comorbidity), which can move an inpatient stay into the "with CC" MS-DRG of its family, unless the principal diagnosis excludes it.

In MS-DRG v44.0, it is part of the grouping logic for DRG 393 (Other Digestive System Diagnoses with MCC, relative weight 1.5881), DRG 394 (Other Digestive System Diagnoses with CC, relative weight 0.9228) and DRG 395 (Other Digestive System Diagnoses without CC/MCC, relative weight 0.6382), in MDC 06 (Diseases and Disorders of the Digestive System), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.