Q16.4

Q16.4: Other congenital malformations of middle ear

Billable / specific codeICD-10-CMPOA exempt

Q16.4 is a billable, specific ICD-10-CM code for other congenital malformations of middle ear. It is valid for submission on a claim.

Check Q16.4 with the rest of the claim: free scrubber

Inclusion terms

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

Congenital malformation of middle ear NOS

Excludes1 inherited from the categories above Q16.4

A category’s note binds every code beneath it.

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

congenital deafness (H90.-)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

Q16.4 is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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

Alphabetic index entries that lead here

Absence›osseous meatus(ear)
Anomaly, anomalous›middle ear
Deformity›middle ear(congenital)
Maldevelopment›middle ear
Malformation›middle ear
Absence›ear, congenital›middle, except ossicles
Anomaly, anomalous›ear›middle(causing impairment of hearing)
Distortion›ear›middle
Hypoplasia, hypoplastic›ear›middle
Imperfect›closure›ear drum(causing impairment of hearing)
Imperfect›closure›tympanic membrane(causing impairment of hearing)
Maldevelopment›middle ear›except ossicles

Code history

Unchanged in every release from FY2024 to FY2027.