Q16.5

Q16.5: Congenital malformation of inner ear

Billable / specific codeICD-10-CMPOA exempt

Q16.5 is a billable, specific ICD-10-CM code for congenital malformation of inner ear. It is valid for submission on a claim.

Check Q16.5 with the rest of the claim: free scrubber

Inclusion terms

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

Congenital anomaly of membranous labyrinth
Congenital anomaly of organ of Corti

Excludes1 inherited from the categories above Q16.5

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

Q16.5 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

Mondini's malformation(cochlea)
Absence›inner ear, congenital
Absence›labyrinth, membranous
Agenesis›labyrinth, membranous
Anomaly, anomalous›labyrinth, membranous
Aplasia›labyrinth, membranous
Collapse›labyrinth, membranous(congenital)
Deformity›organ of Corti(congenital)
Degeneration, degenerative›membranous labyrinth, congenital(causing impairment of hearing)
Degeneration, degenerative›saccule, congenital(causing impairment of hearing)
Dilatation›saccule, congenital
Enlargement, enlarged›vestibular aqueduct

Code history

Unchanged in every release from FY2024 to FY2027.