ICDcodes.org
FY2027

Q16.4 — Other congenital malformations of middle ear

Billable

Is Q16.4 billable?

Yes — Q16.4 is billable for FY2027. Q16.4 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Q16.4 may be submitted for encounters from October 1, 2026 through September 30, 2027.

Q16.4 at a glance

CodeQ16.4
DescriptionOther congenital malformations of middle ear
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

Which MS-DRGs does Q16.4 group to?

Q16.4 sits in MDC 03 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

  • 154Other Ear, Nose, Mouth and Throat Diagnoses with MCCmedical
  • 155Other Ear, Nose, Mouth and Throat Diagnoses with CCmedical
  • 156Other Ear, Nose, Mouth and Throat Diagnoses without CC/MCCmedical

How is Q16.4 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to Q16.4. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Absence › osseous meatus (of) (organ or part) (complete or partial)
  • Anomaly, anomalous › middle ear (congenital) (unspecified type)
  • Deformity › middle ear
  • Maldevelopment › middle ear
  • Malformation › middle ear (congenital)
  • Absence › ear, congenital › middle, except ossicles (of) (organ or part) (complete or partial)
  • Anomaly, anomalous › ear › middle (congenital) (unspecified type)
  • Distortion › ear › middle (s) (congenital)
  • Hypoplasia, hypoplastic › ear › middle
  • Imperfect › closure › ear drum
  • Imperfect › closure › tympanic membrane
  • Maldevelopment › middle ear › except ossicles

Inclusion terms

Alternative wording in documentation that is classified to Q16.4.

  • Congenital malformation of middle ear NOS

Excludes1 — never code together — inherited from Q16

The conditions below can never be reported together with Q16.4 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • congenital deafness (H90.-)

Excludes2 — not included here — inherited from Chapter 17

The conditions below are not part of Q16.4, but a patient may have both at the same time. When documentation supports it, Q16.4 and the excluded code may both be reported.

  • inborn errors of metabolism (E70-E88)

Excludes2 — not included here — inherited from Q10-Q18

The conditions below are not part of Q16.4, but a patient may have both at the same time. When documentation supports it, Q16.4 and the excluded code may both be reported.

  • cleft lip and cleft palate (Q35-Q37)
  • congenital malformation of cervical spine (Q05.0, Q05.5, Q67.5, Q76.0-Q76.4)
  • congenital malformation of larynx (Q31.-)
  • congenital malformation of lip NEC (Q38.0)
  • congenital malformation of nose (Q30.-)
  • congenital malformation of parathyroid gland (Q89.2)
  • congenital malformation of thyroid gland (Q89.2)

How long has Q16.4 existed?

Q16.4 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.

Which conditions are coded to Q16.4?

What other codes are in the Q16 family? (6)