Is Q38 a billable ICD-10-CM code?

No. Q38 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does Q38 sit in the tabular list?

Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Other congenital malformations of the digestive system (Q38-Q45).

What cannot be coded together with Q38?

Q38 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

Q38

Q38 — Other congenital malformations of tongue, mouth and pharynx

Non-billable headerICD-10-CM

Q38 is a non-billable header ICD-10-CM code for other congenital malformations of tongue, mouth and pharynx. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

dentofacial anomalies (M26.-)
macrostomia (Q18.4)
microstomia (Q18.5)

Other codes that can never be billed with Q38

These codes carry an Excludes1 note pointing at Q38. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Q38 alone.

K11.4Fistula of salivary gland
K13.0Diseases of lips
K14.5Plicated tongue

Risk adjustment

Q38 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.

Code to one of these instead Q38

9 child codes. Green means billable.

Questions about Q38

Is Q38 a billable ICD-10-CM code?: No. Q38 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does Q38 sit in the tabular list?: Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Other congenital malformations of the digestive system (Q38-Q45).
What cannot be coded together with Q38?: Q38 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.