Excludes1 pair
Q17.4 vs Q18.2
Q17.4 and Q18.2 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 Q17.4
cervical auricle (Q18.2)
Q17.4
Misplaced ear
Billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q10-Q18
Use when the record says
- Low-set ears
Indexed under
- Melotia
- Displacement, displaced › auricle (congenital)
- Low › set ears
- Misplaced, misplacement › ear
- Malposition › congenital › auricle (ear)
Q18.2
Other branchial cleft malformations
Billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q10-Q18
Use when the record says
- Branchial cleft malformation NOS
- Cervical auricle
- Otocephaly
Indexed under
- Otocephaly
- Auricle, auricular › cervical
- Branchial › cartilage, congenital
- Cervical › auricle
- Cleft › branchial (persistent)
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