Q64.1 ICD-10-CM Code: Exstrophy of urinary bladder

Coder workflow for Q64.1

MedCoder structured workflow — derived from this code’s own official record

Before you code Q64.1

1. Q64.1 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

   ReviewQ64.10, Q64.11, Q64.12, Q64.19

   See the relationships section · Guide: How to choose an ICD-10-CM code →

Choose the right path

1. Does the documentation support one of the more specific codes beneath Q64.1?
   Yes → Select that code and continue the checks below on its own page.
   No → Q64.1 cannot be reported as written; query for the specificity its subcategory needs.

   ReviewQ64.10, Q64.11, Q64.12, Q64.19

Consider Q64.1. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse Q64.1 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of Q64.1 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• Q64.7— Specificity relationship (Review)

  Overlapping diagnoses in the same category.

  Overlapping codes in the same category — the documentation decides which is the more specific fit.

  What moves you there: A record that documents no more than “Other and unspecified congenital malformations of bladder and urethra” takes Q64.7; specificity in the record moves it back here.

  Full comparison: Q64.1 vs Q64.7 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Verify Before Coding

• Not billable as written — a more specific code is required: Q64.10, Q64.11, Q64.12, Q64.19.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Contextual Map

Every relationship of Q64.1 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

• Q00-QA1 — Chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-QA1) (Q00-QA1)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• Q60-Q64 — Congenital malformations of the urinary system[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Nearest codes (25)

• Q64 — Other congenital malformations of urinary system[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• Q64.0 — Epispadias[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• Q64.10 — Exstrophy of urinary bladder, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• Q64.11 — Supravesical fissure of urinary bladder[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• Q64.12 — Cloacal exstrophy of urinary bladder[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• Q64.19 — Other exstrophy of urinary bladder[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• Q64.2 — Congenital posterior urethral valves[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• Q64.3 — Other atresia and stenosis of urethra and bladder neck[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 17 more

Change history

• FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Common coding questions

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to Q64.1 in its code family, with their registry titles.

• Q64 — Other congenital malformations of urinary system
• Q64.0 — Epispadias
• Q64.10 — Exstrophy of urinary bladder, unspecified
• Q64.11 — Supravesical fissure of urinary bladder
• Q64.12 — Cloacal exstrophy of urinary bladder
• Q64.19 — Other exstrophy of urinary bladder
• Q64.2 — Congenital posterior urethral valves
• Q64.3 — Other atresia and stenosis of urethra and bladder neck
• Q64.31 — Congenital bladder neck obstruction
• Q64.32 — Congenital stricture of urethra

View all codes in the Q64 family