Q25.46: Tortuous aortic arch
Q25.46, tortuous aortic arch, is listed as a covered diagnosis in 9 Medicare billing and coding articles that apply to 42 HCPCS Level II codes, including C8925 (Transesophageal echocardiography (tee) with contrast, or…), C8926 (Transesophageal echocardiography (tee) with contrast, or…), C8927 (Transesophageal echocardiography (tee) with contrast, or…). The articles come from 5 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with Q25.46 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| C8925 | Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, real time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report | Special coverage instructions apply | — | 3 |
| C8926 | Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report | Special coverage instructions apply | — | 3 |
| C8927 | Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basis | Special coverage instructions apply | — | 3 |
| Q9957 | Injection, perflutren lipid microspheres, per ml | Carrier judgment | — | 3 |
| Q9956 | Injection, octafluoropropane microspheres, per ml | Carrier judgment | — | 3 |
| Q9955 | Injection, perflexane lipid microspheres, per ml | Carrier judgment | — | 3 |
| J0461 | Injection, atropine sulfate, 0.01 mg | Special coverage instructions apply | — | 3 |
| J0153 | Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) | Special coverage instructions apply | — | 3 |
| J1250 | Injection, dobutamine hydrochloride, per 250 mg | Special coverage instructions apply | — | 3 |
| J0280 | Injection, aminophyllin, up to 250 mg | Special coverage instructions apply | — | 3 |
| J1245 | Injection, dipyridamole, per 10 mg | Special coverage instructions apply | — | 3 |
| A9700 | Supply of injectable contrast material for use in echocardiography, per study | Special coverage instructions apply | — | 3 |
| G0278 | Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure) | Carrier judgment | — | 2 |
| J2785 | Injection, regadenoson, 0.1 mg | Carrier judgment | — | 2 |
| C8921 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete | Special coverage instructions apply | — | 2 |
| C8922 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited study | Special coverage instructions apply | — | 2 |
| C8923 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography | Special coverage instructions apply | — | 2 |
| C8924 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study | Special coverage instructions apply | — | 2 |
| C8928 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report | Special coverage instructions apply | — | 2 |
| C8929 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography | Special coverage instructions apply | — | 2 |
| C8930 | Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision | Special coverage instructions apply | — | 2 |
| G0269 | Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug) | Special coverage instructions apply | — | 1 |
| J3490 | Unclassified drugs | Special coverage instructions apply | — | 1 |
| C9399 | Unclassified drugs or biologicals | Special coverage instructions apply | — | 1 |
| C8900 | Magnetic resonance angiography with contrast, abdomen | Special coverage instructions apply | — | 1 |
17 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing Q25.46
- A56809: Billing and Coding: Transesophageal Echocardiography (TEE) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33579, L34337, L35016
- A56505: Billing and Coding: Transesophageal Echocardiography (TEE) (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L33579, L34337, L35016
- A52850: Billing and Coding: Cardiac Catheterization and Coronary Angiography (Wellpoint Federal (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L33557, L33959
- A52868: Billing and Coding: Transesophageal Echocardiography (TEE) (Wellpoint Federal (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33579, L34337, L35016
- A57306: Billing and Coding: Transthoracic Echocardiography (TTE) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 19 Level II codes). LCD with the same title: L33577, L34338
- A56775: Billing and Coding: Magnetic Resonance Angiography (Palmetto GBA (MAC - Part A, MAC - Part B); 18 Level II codes). LCD with the same title: L34424
- A57056: Billing and Coding: Aortography and Peripheral Angiography (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L36767
- A56781: Billing and Coding: Transthoracic Echocardiography (TTE) (Wellpoint Federal (MAC - Part A, MAC - Part B); 17 Level II codes). LCD with the same title: L33577, L34338
- A56625: Billing and Coding: Echocardiography (Palmetto GBA (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L37379
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other Q25 diagnoses (Congenital malformations of great arteries)
- Q25.40 — Congenital malformation of aorta unspecified
- Q25.41 — Absence and aplasia of aorta
- Q25.42 — Hypoplasia of aorta
- Q25.43 — Congenital aneurysm of aorta
- Q25.44 — Congenital dilation of aorta
- Q25.45 — Double aortic arch
- Q25.47 — Right aortic arch
- Q25.48 — Anomalous origin of subclavian artery
- Q25.49 — Other congenital malformations of aorta
- Q25.0 — Patent ductus arteriosus
- Q25.1 — Coarctation of aorta
- Q25.21 — Interruption of aortic arch
- Q25.29 — Other atresia of aorta
- Q25.3 — Supravalvular aortic stenosis
- Q25.5 — Atresia of pulmonary artery
- Q25.6 — Stenosis of pulmonary artery
- Q25.71 — Coarctation of pulmonary artery
- Q25.72 — Congenital pulmonary arteriovenous malformation
- Q25.79 — Other congenital malformations of pulmonary artery
- Q25.8 — Other congenital malformations of other great arteries
- Q25.9 — Congenital malformation of great arteries, unspecified
Frequently asked questions
Does Medicare cover Q25.46 (Tortuous aortic arch)?
Medicare covers items and services, not diagnoses. 9 Medicare billing and coding articles list Q25.46 as a covered diagnosis for 42 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 Q25.46?
The Level II codes from the policies most specific to this diagnosis are C8925 (Transesophageal echocardiography (tee) with contrast, or…, 3 articles); C8926 (Transesophageal echocardiography (tee) with contrast, or…, 3 articles); C8927 (Transesophageal echocardiography (tee) with contrast, or…, 3 articles); Q9957 (Injection, perflutren lipid microspheres, per ml, 3 articles); Q9956 (Injection, octafluoropropane microspheres, per ml, 3 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list Q25.46?
A56809 (Billing and Coding: Transesophageal Echocardiography (TEE)); A56505 (Billing and Coding: Transesophageal Echocardiography (TEE)); A52850 (Billing and Coding: Cardiac Catheterization and Coronary Angiography), and 6 more articles.
What is ICD-10-CM code Q25.46?
Q25.46 is the ICD-10-CM code for tortuous aortic arch, in category Q25 (Congenital malformations of great arteries), chapter 17: Congenital malformations and chromosomal abnormalities.
Next steps
- Run a reimbursement report for a device billed under C8925
- Watch C8925 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for C8925
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 17: Congenital malformations and chromosomal abnormalities · All diagnoses · HCPCS lookup