Is Q55.7 a billable ICD-10-CM code?

Yes. Q55.7 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Q55.7 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 Q55.7?

Q55.7 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Q55.7 (Q55) and apply to it just the same.

Q55.7

Q55.7 — Congenital vasocutaneous fistula

Billable / specific codeICD-10-CMPOA exempt

Q55.7 is a billable, specific ICD-10-CM code for congenital vasocutaneous fistula. It is valid for submission on a claim.

Excludes1 inherited from the categories above Q55.7

These are not written on Q55.7, but they bind it: a note on a category applies to every code beneath it. Billing Q55.7 with anything listed here is a denial.

Written on Q55 — Other congenital malformations of male genital organs

congenital hydrocele (P83.5)
hypospadias (Q54.-)

Risk adjustment

Q55.7 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

Q55.7 is named in 1 Medicare coverage policy — 1 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

How Q55.7 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 Q55.7.

Fistula›vasocutaneous, congenital

Code history

Q55.7 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share Q55. If Q55.7 is not quite right, the correct code is usually one of these.

Questions about Q55.7

Is Q55.7 a billable ICD-10-CM code?: Yes. Q55.7 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Q55.7 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 Q55.7?: Q55.7 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Q55.7 (Q55) and apply to it just the same.