Q12 vs Q38.0
Q12 (Congenital lens malformations) compared with Q38.0 (Congenital malformations of lips, not elsewhere classified), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. Q12 carries an Excludes2 note covering Q38.0: “congenital malformation of lip NEC (Q38.0)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| Q12Congenital lens malformations | Q38.0Congenital malformations of lips, not elsewhere classified | |
|---|---|---|
| Billing status | Non-billable header | Billable |
| Classification | Q00-Q99 — Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99) | Q00-Q99 — Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99) |
| Definition | Congenital lens malformations is a non-billable ICD-10-CM category code (Q12). | Congenital malformations of lips, not elsewhere classified is a billable ICD-10-CM diagnosis code (Q38.0). |
| Includes | — | Congenital fistula of lip Congenital malformation of lip NOS Van der Woude's syndrome |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources