FY2027
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Excludes1 pair

Q18.7 vs Q38.0

Q18.7 and Q38.0 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 Q38.0
microcheilia (Q18.7)
Q18.7

Microcheilia

Billable
Chapter 17
Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Section
Q10-Q18
Indexed under
  • Microcheilia
Q38.0

Congenital malformations of lips, not elsewhere classified

BillableUnspecified
Chapter 17
Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Section
Q38-Q45
Use when the record says
  • Congenital fistula of lip
  • Congenital malformation of lip NOS
  • Van der Woude's syndrome
Indexed under
  • Van der Woude's syndrome
  • Agenesis › lip
  • Anomaly, anomalous › lip
  • Malformation › lip
  • Deformity › lip NEC › congenital

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