I42.4 vs Q24
I42.4 and Q24 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on Q24
endocardial fibroelastosis (I42.4)
I42.4
Endocardial fibroelastosis
Billable
- Chapter 9
- Diseases of the circulatory system
- Section
- I30-I5A
Use when the record says
- Congenital cardiomyopathy
- Elastomyofibrosis
Indexed under
- Elastomyofibrosis
- Fibroelastosis (cordis) (endocardial) (endomyocardial)
- Cardiomyopathy › congenital (familial) (idiopathic)
- Sclerosis, sclerotic › subendocardial, congenital
- Anomaly, anomalous › heart › fibroelastosis cordis (congenital) (unspecified type)
Q24
Other congenital malformations of heart
Not billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q20-Q28
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027