L68 vs Q84.2
L68 and Q84.2 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 L68
congenital hypertrichosis (Q84.2)
L68
Hypertrichosis
Not billable
- Chapter 12
- Diseases of the skin and subcutaneous tissue
- Section
- L60-L75
Use when the record says
- excess hair
Q84.2
Other congenital malformations of hair
Billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q80-Q89
Use when the record says
- Congenital hypertrichosis
- Congenital malformation of hair NOS
- Persistent lanugo
Indexed under
- Anomaly, anomalous › hair (congenital) (unspecified type)
- Canities › congenital (premature)
- Grayness, hair › congenital (premature)
- Hypertrichosis › congenital
- Hypertrichosis › lanuginosa
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