Q18.6 vs Q38.0
Q18.6 (Macrocheilia) compared with Q38.0 (Congenital malformations of lips, not elsewhere classified), 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?
Yes, when both are documented. Q18.6 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.
No — do not report together. Q38.0 carries an Excludes1 note covering Q18.6: “macrocheilia (Q18.6)”
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
| Q18.6Macrocheilia | Q38.0Congenital malformations of lips, not elsewhere classified | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | Q00-Q99 — Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99) | Q00-Q99 — Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99) |
| Definition | Macrocheilia is a billable ICD-10-CM diagnosis code (Q18.6). | Congenital malformations of lips, not elsewhere classified is a billable ICD-10-CM diagnosis code (Q38.0). |
| Includes | Hypertrophy of lip, congenital | 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