Q18.5
Q18.5: Microstomia
Billable / specific codeICD-10-CMPOA exempt
Q18.5 is a billable, specific ICD-10-CM code for microstomia. It is valid for submission on a claim.
Check Q18.5 with the rest of the claim: free scrubberExcludes1 inherited from the categories above Q18.5
A category’s note binds every code beneath it.
Written on Q18: Other congenital malformations of face and neck
Other codes that can never be billed with Q18.5
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
Q18.5 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
- Microstomia(congenital)
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under Q18
- Q18.0Sinus, fistula and cyst of branchial cleft
- Q18.1Preauricular sinus and cyst
- Q18.2Other branchial cleft malformations
- Q18.3Webbing of neck
- Q18.4Macrostomia
- Q18.6Macrocheilia
- Q18.7Microcheilia
- Q18.8Other specified congenital malformations of face and neck
- Q18.9Congenital malformation of face and neck, unspecified