Q43.7 — Persistent cloaca
Q43.7 is a billable, specific ICD-10-CM code for persistent cloaca. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Cloaca NOS
Other codes that can never be billed with Q43.7
These codes carry an Excludes1 note pointing at Q43.7. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Q43.7 alone.
- Q52.2Congenital rectovaginal fistula
Risk adjustment
Q43.7 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.
Medicare coverage
Q43.7 is named in 3 Medicare coverage policies — 3 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
- A56632Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
How Q43.7 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 Q43.7.
- Cloaca(persistent)
- Persistence, persistent›cloaca
Related codes at this level
Codes that share Q43. If Q43.7 is not quite right, the correct code is usually one of these.
- Q43.0Meckel's diverticulum (displaced) (hypertrophic)
- Q43.1Hirschsprung's disease
- Q43.2Other congenital functional disorders of colon
- Q43.3Congenital malformations of intestinal fixation
- Q43.4Duplication of intestine
- Q43.5Ectopic anus
- Q43.6Congenital fistula of rectum and anus
- Q43.8Other specified congenital malformations of intestine
- Q43.9Congenital malformation of intestine, unspecified
Questions about Q43.7
- Is Q43.7 a billable ICD-10-CM code?
- Yes. Q43.7 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Q43.7 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).