FY2027
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Excludes1 pair

Q30- vs Q67.4

Q30 and Q67.4 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 Q30
congenital deviation of nasal septum (Q67.4)
Q30

Congenital malformations of nose

Not billable
Chapter 17
Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Section
Q30-Q34
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
  • Depression › skull
  • Flattening › nose (congenital)
  • 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