K14.5 vs Q38.3
K14.5 and Q38.3 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 K14.5
fissured tongue, congenital (Q38.3)
K14.5
Plicated tongue
Billable
- Chapter 11
- Diseases of the digestive system
- Section
- K00-K14
Use when the record says
- Fissured tongue
- Furrowed tongue
- Scrotal tongue
Indexed under
- Furrowed
- Grooved tongue
- Plicated tongue
- Scrotal tongue
- Fissure, fissured › tongue
Q38.3
Other congenital malformations of tongue
Billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q38-Q45
Use when the record says
- Aglossia
- Bifid tongue
- Congenital adhesion of tongue
- Congenital fissure of tongue
- Congenital malformation of tongue NOS
- Double tongue
- Hypoglossia
- Hypoplasia of tongue
Indexed under
- Aglossia (congenital)
- Hypoglossia
- Microglossia (congenital)
- Absence › tongue, congenital (of) (organ or part) (complete or partial)
- Accessory › tongue (congenital)
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