Is Q16.5 a billable ICD-10-CM code?

Yes. Q16.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Q16.5 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).

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.

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

Risk adjustment

Q16.5 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

Q16.5 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 Q16.5 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 Q16.5.

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

Related codes at this level

Codes that share Q16. If Q16.5 is not quite right, the correct code is usually one of these.

Questions about Q16.5

Is Q16.5 a billable ICD-10-CM code?: Yes. Q16.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Q16.5 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).