Excludes1 pair
Q04- vs Q75.3
Q04 and Q75.3 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.
The official note, declared on Q04
macrocephaly (Q75.3)
Q04
Other congenital malformations of brain
Not billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q00-Q07
Q75.3
Macrocephaly
Billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q65-Q79
Indexed under
- Macrocephalia, macrocephaly
- Megalocephalus, megalocephaly NEC
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