I60.8 vs Q28
I60.8 and Q28 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 Q28
ruptured cerebral arteriovenous malformation (I60.8)
I60.8
Other nontraumatic subarachnoid hemorrhage
Billable
- Chapter 9
- Diseases of the circulatory system
- Section
- I60-I69
Use when the record says
- Meningeal hemorrhage
- Rupture of cerebral arteriovenous malformation
Indexed under
- Anastomosis › arteriovenous ruptured brain
- Hemorrhage, hemorrhagic › membrane (concealed)
- Hemorrhage, hemorrhagic › meninges, meningeal (concealed)
- Rupture, ruptured › meningeal artery
- Anastomosis › arteriovenous ruptured brain › subarachnoid
Q28
Other congenital malformations of circulatory system
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