Q18 vs Q67.4
Q18 and Q67.4 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on Q18
conditions classified to Q67.0-Q67.4
Q18
Other congenital malformations of face and neck
Not billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q10-Q18
Q67.4
Other congenital deformities of skull, face and jaw
Billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q65-Q79
Use when the record says
- Congenital depressions in skull
- Congenital hemifacial atrophy or hypertrophy
- Deviation of nasal septum, congenital
- Squashed or bent nose, congenital
Indexed under
- Atrophy, atrophic › hemifacial (of)
- Depression › skull (acute) (mental)
- Flattening › nose
- Friedreich's › facial hemihypertrophy
- Hypertrophy, hypertrophic › hemifacial
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