Is ICD-10-CM code Q18 billable?

No, Q18 (Other congenital malformations of face and neck) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code Q18 belong to?

Q18 belongs to Chapter 17 of the ICD-10-CM tabular list: Q00–Q99 (Congenital Malformations, Deformations and Chromosomal Abnormalities).

Q18Not billable, use a more specific code below

Other congenital malformations of face and neck

In Congenital malformations of eye, ear, face and neck (Q10-Q18), chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities

10 billable codes under Q18: none are a CC or MCC; none map to an HCC.

Instructional notes

Excludes1: not coded here, use a different code

cleft lip and cleft palate (Q35-Q37)
conditions classified to Q67.0-Q67.4
congenital malformations of skull and face bones (Q75.-)
cyclopia (Q87.0)
dentofacial anomalies [including malocclusion] (M26.-)
malformation syndromes affecting facial appearance (Q87.0)
persistent thyroglossal duct (Q89.2)

Also applies, from Congenital malformations of eye, ear, face and neck (Q10-Q18)

These notes sit on Q10-Q18 and apply to every code under it, including Q18.

Excludes2: not included here, code separately if applicable

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)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Assign Q00-QA1 codes for documented congenital anomalies or genetic disorders at any age, coding non-inherent manifestations separately and sequencing Z38 first on the birth admission.

Read Section I.C.17 (page 74)

All codes under Q18

Q18 can't be used on a claim. Pick a billable code below; grey headings group them.

Q18 MS-DRGs

As the principal diagnosis, the billable codes under Q18 group to these 8 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 154 Other Ear, Nose, Mouth and Throat Diagnoses with MCC (4 of 10 codes)
DRG 155 Other Ear, Nose, Mouth and Throat Diagnoses with CC (4 of 10 codes)
DRG 156 Other Ear, Nose, Mouth and Throat Diagnoses without CC/MCC (4 of 10 codes)
DRG 157 Dental and Oral Diseases with MCC (4 of 10 codes)
DRG 158 Dental and Oral Diseases with CC (4 of 10 codes)
DRG 159 Dental and Oral Diseases without CC/MCC (4 of 10 codes)
DRG 606 Minor Skin Disorders with MCC (2 of 10 codes)
DRG 607 Minor Skin Disorders without MCC (2 of 10 codes)

Other codes that refer to Q18

Notes on these codes point to Q18.

Q75 Excludes1: congenital malformation of face NOS (Q18.-)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Craniofacial Abnormalities

Craniofacial is a medical term that relates to the bones of the skull and face. Craniofacial abnormalities are birth defects of the face or head. Some, like cleft lip and palate, are among the most common of all birth defects. Others are very rare. Most of them affect how a person's face or head looks. These conditions may also affect other parts of the body.

Neck Injuries and Disorders

Any part of your neck - muscles, bones, joints, tendons, ligaments, or nerves - can cause neck problems. Neck pain is very common. Pain may also come from your shoulder, jaw, head, or upper arms.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.