Q04 vs Q75.3
Q04 and Q75.3 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 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