Is ICD-10-CM code Q55 billable?

No, Q55 (Other congenital malformations of male genital organs) 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 Q55 belong to?

Q55 belongs to Chapter 17 of the ICD-10-CM tabular list: Q00–Q99 (Congenital Malformations, Deformations and Chromosomal Abnormalities).

Q55Not billable, use a more specific code below

Other congenital malformations of male genital organs

In Congenital malformations of genital organs (Q50-Q56), chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities

18 billable codes under Q55: none are a CC or MCC; none map to an HCC.

Instructional notes

Excludes1: not coded here, use a different code

congenital hydrocele (P83.5)
hypospadias (Q54.-)

Also applies, from Congenital malformations of genital organs (Q50-Q56)

These notes sit on Q50-Q56 and apply to every code under it, including Q55.

Excludes1: not coded here, use a different code

androgen insensitivity syndrome (E34.5-)
syndromes associated with anomalies in the number and form of chromosomes (Q90-Q99)

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 Q55

Q55 can't be used on a claim. Pick a billable code below; grey headings group them.

Q55 MS-DRGs

As the principal diagnosis, the billable codes under Q55 group to MS-DRG 729, 730, or 795 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 729 Other Male Reproductive System Diagnoses with CC/MCC (18 of 18 codes)
DRG 730 Other Male Reproductive System Diagnoses without CC/MCC (18 of 18 codes)
DRG 795 Normal Newborn (1 of 18 codes)

About the condition

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

Penis Disorders

Problems with the penis can cause pain and affect a man's sexual function and fertility. Penis disorders include:

Testicular Disorders

Testicles, or testes, make male hormones and sperm. They are two egg-shaped organs inside the scrotum, the loose sac of skin behind the penis. It's easy to injure your testicles because they are not protected by bones or muscles. Men and boys should wear athletic supporters when they play sports.

Code history

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