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Q20 vs Q89.3

Q20 (Congenital malformations of cardiac chambers and connections) compared with Q89.3 (Situs inversus), 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. Q20 carries an Excludes1 note covering Q89.3: “dextrocardia with situs inversus (Q89.3)”

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. Q20 carries an Excludes1 note covering Q89.3: “mirror-image atrial arrangement with situs inversus (Q89.3)”

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

Q20Congenital malformations of cardiac chambers and connectionsQ89.3Situs inversus
Billing statusNon-billable header

Report instead: Q20.0, Q20.1, Q20.2, Q20.3, Q20.4

Billable
ClassificationQ00-Q99 — Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99)Q00-Q99 — Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99)
DefinitionCongenital malformations of cardiac chambers and connections is a non-billable ICD-10-CM category code (Q20).Situs inversus is a billable ICD-10-CM diagnosis code (Q89.3).
Includes
Dextrocardia with situs inversus
Mirror-image atrial arrangement with situs inversus
Situs inversus or transversus abdominalis
Situs inversus or transversus thoracis

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