Is Q38.7 a billable ICD-10-CM code?

Yes. Q38.7 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Q38.7 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 Q38.7?

Q38.7 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

Q38.7

Q38.7 — Congenital pharyngeal pouch

Billable / specific codeICD-10-CMPOA exempt

Q38.7 is a billable, specific ICD-10-CM code for congenital pharyngeal pouch. It is valid for submission on a claim.

Excludes1 — never code together

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

pharyngeal pouch syndrome (D82.1)

Inclusion terms

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

Congenital diverticulum of pharynx

Risk adjustment

Q38.7 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.

How Q38.7 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 Q38.7.

Diverticulum, diverticula›pharynx(congenital)
Pouch›pharynx, pharyngeal(congenital)

Related codes at this level

Codes that share Q38. If Q38.7 is not quite right, the correct code is usually one of these.

Questions about Q38.7

Is Q38.7 a billable ICD-10-CM code?: Yes. Q38.7 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Q38.7 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 Q38.7?: Q38.7 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.