Is Q16.3 a billable ICD-10-CM code?

Yes. Q16.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Q16.3 sit in the tabular list?

Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Congenital malformations of eye, ear, face and neck (Q10-Q18).

What cannot be coded together with Q16.3?

Q16.3 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Q16.3 (Q16) and apply to it just the same.

Q16.3

Q16.3 — Congenital malformation of ear ossicles

Billable / specific codeICD-10-CMPOA exempt

Q16.3 is a billable, specific ICD-10-CM code for congenital malformation of ear ossicles. It is valid for submission on a claim.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Congenital fusion of ear ossicles

Excludes1 inherited from the categories above Q16.3

These are not written on Q16.3, but they bind it: a note on a category applies to every code beneath it. Billing Q16.3 with anything listed here is a denial.

Written on Q16 — Congenital malformations of ear causing impairment of hearing

congenital deafness (H90.-)

Risk adjustment

Q16.3 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

Q16.3 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
A57204Billing and Coding: MRI and CT Scans of the Head and Neck

How Q16.3 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to Q16.3.

Accessory›auditory ossicles
Agenesis›incus
Distortion›ossicles, ear
Fusion, fused›ear ossicles
Maldevelopment›ossicles
Persistence, persistent›arteria stapedia
Supernumerary›auditory ossicles
Supernumerary›ossicles, auditory
Absence›ear, congenital›ossicles
Absence›incus›congenital
Anomaly, anomalous›ear›ossicles
Anomaly, anomalous›middle ear›ossicles

Code history

Q16.3 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share Q16. If Q16.3 is not quite right, the correct code is usually one of these.

Questions about Q16.3

Is Q16.3 a billable ICD-10-CM code?: Yes. Q16.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Q16.3 sit in the tabular list?: Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Congenital malformations of eye, ear, face and neck (Q10-Q18).
What cannot be coded together with Q16.3?: Q16.3 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Q16.3 (Q16) and apply to it just the same.