Is Q52.2 a billable ICD-10-CM code?

Yes. Q52.2 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Q52.2 sit in the tabular list?

Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Congenital malformations of genital organs (Q50-Q56).

What cannot be coded together with Q52.2?

Q52.2 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

Q52.2

Q52.2 — Congenital rectovaginal fistula

Billable / specific codeICD-10-CMPOA exempt

Q52.2 is a billable, specific ICD-10-CM code for congenital rectovaginal fistula. 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.

cloaca (Q43.7)

Other codes that can never be billed with Q52.2

These codes carry an Excludes1 note pointing at Q52.2. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Q52.2 alone.

Q43.6Congenital fistula of rectum and anus

Risk adjustment

Q52.2 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 Q52.2 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 Q52.2.

Fistula›enterovaginal›congenital
Fistula›rectovaginal›congenital

Related codes at this level

Codes that share Q52. If Q52.2 is not quite right, the correct code is usually one of these.

Questions about Q52.2

Is Q52.2 a billable ICD-10-CM code?: Yes. Q52.2 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Q52.2 sit in the tabular list?: Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Congenital malformations of genital organs (Q50-Q56).
What cannot be coded together with Q52.2?: Q52.2 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.