Is Q74.1 a billable ICD-10-CM code?

Yes. Q74.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Q74.1 sit in the tabular list?

Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Congenital malformations and deformations of the musculoskeletal system (Q65-Q79).

What cannot be coded together with Q74.1?

Q74.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

Q74.1

Q74.1 — Congenital malformation of knee

Billable / specific codeICD-10-CMPOA exempt

Q74.1 is a billable, specific ICD-10-CM code for congenital malformation of knee. 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.

congenital dislocation of knee (Q68.2)
congenital genu recurvatum (Q68.2)
nail patella syndrome (Q87.2)

Inclusion terms

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

Congenital absence of patella
Congenital dislocation of patella
Congenital genu valgum
Congenital genu varum
Rudimentary patella

Risk adjustment

Q74.1 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

Q74.1 is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52465Knee Orthoses - Policy Article
A52465Knee Orthoses - Policy Article
A53058Billing and Coding: Home Health Physical Therapy
A53065Billing and Coding: Outpatient Physical Therapy

How Q74.1 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 Q74.1.

Absence›patella, congenital
Agenesis›patella
Anomaly, anomalous›knee
Anomaly, anomalous›patella
Bifid›patella
Biparta, bipartite›patella
Elongated, elongation›ligamentum patellae
Genu›congenital
Hypertrophy, hypertrophic›meniscus, knee, congenital
Hypoplasia, hypoplastic›patella
Knock knee›congenital
Rudimentary›patella

Related codes at this level

Codes that share Q74. If Q74.1 is not quite right, the correct code is usually one of these.

Questions about Q74.1

Is Q74.1 a billable ICD-10-CM code?: Yes. Q74.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Q74.1 sit in the tabular list?: Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Congenital malformations and deformations of the musculoskeletal system (Q65-Q79).
What cannot be coded together with Q74.1?: Q74.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.