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.

Check Q74.1 with the rest of the claim: free scrubber

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

Excludes1 inherited from the categories above Q74.1

A category’s note binds every code beneath it.

Written on Q74: Other congenital malformations of limb(s)

polydactyly (Q69.-)
reduction defect of limb (Q71-Q73)
syndactyly (Q70.-)

Other codes that can never be billed with Q74.1

Their own Excludes1 notes name this code, so the conflict is not listed above.

M20Acquired deformities of fingers and toes

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

Q74.1 is named in 3 Medicare coverage policies: 3 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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

Alphabetic index entries that lead here

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

Code history

Unchanged in every release from FY2024 to FY2027.