FY2027
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Excludes1 pair

Q87- vs Q89.7

Q87 and Q89.7 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 Q89.7
congenital malformation syndromes affecting multiple systems (Q87.-)
Q87

Other specified congenital malformation syndromes affecting multiple systems

Not billable
Chapter 17
Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Section
Q80-Q89
Q89.7

Multiple congenital malformations, not elsewhere classified

BillableUnspecified
Chapter 17
Congenital malformations, deformations, chromosomal abnormalities, and genetic disorders
Section
Q80-Q89
Use when the record says
  • Multiple congenital anomalies NOS
  • Multiple congenital deformities NOS
Indexed under
  • Monster, monstrosity (single)
  • Paracephalus
  • Teratism
  • Anomaly, anomalous › multiple NEC
  • Deformity › multiple, congenital NEC

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