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M21.4 vs Q66.5

M21.4 (Flat foot pes planus) compared with Q66.5 (Congenital pes planus), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. M21.4 carries an Excludes1 note covering Q66.5: “congenital pes planus (Q66.5-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

No — do not report together. M21.4 carries an Excludes1 note covering Q66.5: “congenital deformities and malformations of limbs (Q65-Q66, Q68-Q74)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

No — do not report together. Q66.5 carries an Excludes1 note covering M21.4: “pes planus, acquired (M21.4)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

M21.4Flat foot pes planusQ66.5Congenital pes planus
Billing statusNon-billable header

Report instead: M21.40, M21.41, M21.42

Non-billable header

Report instead: Q66.50, Q66.51, Q66.52

ClassificationM00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)Q00-Q99 — Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99)
DefinitionFlat foot pes planus is a non-billable ICD-10-CM category code (M21.4).Congenital pes planus is a non-billable ICD-10-CM category code (Q66.5).
Includes
Congenital flat foot
Congenital rigid flat foot
Congenital spastic (everted) flat foot

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources