Q20.6 vs Q24.0
Q20.6 and Q24.0 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 Q24.0
isomerism of atrial appendages (with asplenia or polysplenia) (Q20.6)
Q20.6
Isomerism of atrial appendages
Billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q20-Q28
Use when the record says
- Isomerism of atrial appendages with asplenia or polysplenia
Indexed under
- Isomerism atrial appendages (with asplenia or polysplenia)
Q24.0
Dextrocardia
Billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q20-Q28
Indexed under
- Dextrocardia (true)
- Transposition › heart (congenital)
- Malposition › congenital › heart › dextrocardia
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