Excludes1 pair
Q20- vs Q89.3
Q20 and Q89.3 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 Q20
dextrocardia with situs inversus (Q89.3)
Q20
Congenital malformations of cardiac chambers and connections
Not billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q20-Q28
Q89.3
Situs inversus
Billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q80-Q89
Use when the record says
- Dextrocardia with situs inversus
- Mirror-image atrial arrangement with situs inversus
- Situs inversus or transversus abdominalis
- Situs inversus or transversus thoracis
- Transposition of abdominal viscera
- Transposition of thoracic viscera
Indexed under
- Kartagener's syndrome or triad (sinusitis, bronchiectasis, situs inversus)
- Sinusitis-bronchiectasis-situs inversus (syndrome) (triad)
- Situs inversus or transversus (abdominalis) (thoracis)
- Levocardia › with situs inversus
- Syndrome › Kartagener's
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