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Code
Description

ICD-10-CM Code Q16.4
Other congenital malformations of middle ear

BILLABLE
Billable Code
Billable codes are sufficient justification for admission to an acute care hospital when used a principal diagnosis.
POA Exempt
POA Exempt Code
The Center for Medicare & Medicaid Services (CMS) requires medical coders to indicate whether or not a condition was present at the time of admission, in order to properly assign MS-DRG codes. This "Present On Admission" (POA) indicator is recorded on CMS form 4010A.
| ICD-10 from 2011 - 2016

Q16.4 is a billable ICD code used to specify a diagnosis of other congenital malformations of middle ear. A 'billable code' is detailed enough to be used to specify a medical diagnosis.

POA Indicators on CMS form 4010A are as follows:

IndicatorMeaningCMS Will Pay CC/MCC DRG Costs
YDiagnosis was present at time of inpatient admissionYes
NDiagnosis was not present at time of inpatient admissionNo
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.No
WClinically undetermined. Provider unable to clinically determine whether the condition was present at the time of inpatient admission.Yes
1Exempt from POA reportingNo


Coding Notes for Q16.4 Info for medical coders on how to properly use this ICD-10 code

Inclusion Terms:
Inclusion Terms
Inclusion Terms are a list of concepts for which a specific code is used. The list of Inclusion Terms is useful for determining the correct code in some cases, but the list is not necessarily exhaustive.
Congenital malformation of middle ear NOS

MS-DRG Mapping

  • DRG Group #154-156 - Other ear, nose, mouth and throat diagnoses with MCC.
  • DRG Group #154-156 - Other ear, nose, mouth and throat diagnoses with CC.
  • DRG Group #154-156 - Other ear, nose, mouth and throat diagnoses without CC or MCC.

Equivalent ICD-9 Code GENERAL EQUIVALENCE MAPPINGS (GEM)

Anomaly of middle ear, except ossicles (exact match)

This is the official exact match mapping between ICD9 and ICD10, as provided by the General Equivalency mapping crosswalk. This means that in all cases where the ICD9 code 744.03 was previously used, Q16.4 is the appropriate modern ICD10 code.


Parent Code: Q16 - Congenital malformations of ear causing impairment of hearing

** This Document Provided By ICD.Codes **
Source: http://icd.codes/icd10cm/Q164