FY2027
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Excludes1 pair

Q11.2 vs Q87.0

Q11.2 and Q87.0 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 Q11.2
cryptophthalmos syndrome (Q87.0)
Q11.2

Microphthalmos

Billable
Chapter 17
Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Section
Q10-Q18
Use when the record says
  • Cryptophthalmos NOS
  • Dysplasia of eye
  • Hypoplasia of eye
  • Rudimentary eye
Indexed under
  • Cryptophthalmos
  • Microphthalmos, microphthalmia (congenital)
  • Dysplasia › eye (congenital)
  • Hypoplasia, hypoplastic › eye
  • Rudimentary › eye
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