Q74.1 vs Q87.2
Q74.1 and Q87.2 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 Q74.1
nail patella syndrome (Q87.2)
Q74.1
Congenital malformation of knee
Billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q65-Q79
Use when the record says
- Congenital absence of patella
- Congenital dislocation of patella
- Congenital genu valgum
- Congenital genu varum
- Rudimentary patella
Indexed under
- Absence › patella, congenital (of) (organ or part) (complete or partial)
- Agenesis › patella
- Anomaly, anomalous › knee (congenital) (unspecified type)
- Anomaly, anomalous › patella (congenital) (unspecified type)
- Bifid › patella (congenital)
Q87.2
Congenital malformation syndromes predominantly involving limbs
Billable
- Chapter 17
- Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
- Section
- Q80-Q89
Use when the record says
- Holt-Oram syndrome
- Klippel-Trenaunay-Weber syndrome
- Nail patella syndrome
- Rubinstein-Taybi syndrome
- Sirenomelia syndrome
- Thrombocytopenia with absent radius [TAR] syndrome
- VATER syndrome
Indexed under
- Fong's syndrome (hereditary osteo-onychodysplasia)
- Holt-Oram syndrome
- Klippel-Trenaunaysyndrome (-Weber)
- Mietens' syndrome
- Onycho-osteodysplasia
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