FY2027
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Excludes1 pair

Q76.6 vs Q77.2

Q76.6 and Q77.2 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 Q76.6
short rib syndrome (Q77.2)
Q76.6

Other congenital malformations of ribs

Billable
Chapter 17
Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Section
Q65-Q79
Use when the record says
  • Accessory rib
  • Congenital absence of rib
  • Congenital fusion of ribs
  • Congenital malformation of ribs NOS
Indexed under
  • Accessory › rib
  • Agenesis › rib
  • Anomaly, anomalous › rib
  • Bifurcation › rib
  • Extra › rib
Q77.2

Short rib syndrome

Billable
Chapter 17
Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Section
Q65-Q79
Use when the record says
  • Asphyxiating thoracic dysplasia [Jeune]
Indexed under
  • Jeune's disease
  • Dysplasia › asphyxiating thoracic (congenital)
  • Dystrophy, dystrophia › thoracic, asphyxiating
  • Short, shortening, shortness › rib syndrome
  • Syndrome › short › rib

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