FY2027
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Excludes1 pair

Q05- vs Q76.0

Q05 and Q76.0 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 Q05
spina bifida occulta (Q76.0)
Q05

Spina bifida

Not billable
Chapter 17
Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Section
Q00-Q07
Use when the record says
  • hydromeningocele (spinal)
  • meningocele (spinal)
  • meningomyelocele
  • myelocele
  • myelomeningocele
  • rachischisis
  • spina bifida (aperta)(cystica)
  • syringomyelocele
Q76.0

Spina bifida occulta

Billable
Chapter 17
Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Section
Q65-Q79
Indexed under
  • Spina bifida › occulta

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