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