Q04 vs Q87.0
Q04 and Q87.0 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
cyclopia (Q87.0)
Q04
Other congenital malformations of brain
Not billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q00-Q07
Q87.0
Congenital malformation syndromes predominantly affecting facial appearance
Billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q80-Q89
Use when the record says
- Acrocephalopolysyndactyly
- Acrocephalosyndactyly [Apert]
- Cryptophthalmos syndrome
- Cyclopia
- Goldenhar syndrome
- Moebius syndrome
- Oro-facial-digital syndrome
- Robin syndrome
Indexed under
- Acrocephalopolysyndactyly
- Acrocephalosyndactyly
- Aglossia-adactylia syndrome
- Apert's syndrome
- Carpenter's syndrome
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