Q64.7 vs Q79.4
Q64.7 and Q79.4 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 Q64.7
congenital prolapse of bladder (mucosa) (Q79.4)
Q64.7
Other and unspecified congenital malformations of bladder and urethra
Not billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q60-Q64
Q79.4
Prune belly syndrome
Billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q65-Q79
Use when the record says
- Congenital prolapse of bladder mucosa
- Eagle-Barrett syndrome
Indexed under
- Prune belly (syndrome)
- Abdomen, abdominal › muscle deficiency syndrome
- Aplasia › abdominal muscle syndrome
- Deficiency, deficient › abdominal muscle syndrome
- Syndrome › Eagle-Barrett
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