Excludes1 pair

Q16.9 vs Q17-

Q16.9 and Q17 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 Q17
congenital malformations of ear with impairment of hearing (Q16.0-Q16.9)
Q16.9

Congenital malformation of ear causing impairment of hearing, unspecified

BillableUnspecified
Chapter 17
Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Section
Q10-Q18
Use when the record says
  • Congenital absence of ear NOS
Indexed under
  • Absence › ear, congenital
  • Agenesis › ear
  • Anomaly, anomalous › ear › causing impairment of hearing
  • Hypoplasia, hypoplastic › auditory canal › causing impairment of hearing
  • Malformation › ear › causing impairment of hearing
Q17

Other congenital malformations of ear

Not billable
Chapter 17
Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Section
Q10-Q18

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