2027 ICD-10-CM Diagnosis Code Q16.4Other congenital malformations of middle ear

ICD-10-CM Codes›Q00-Q99›Q10-Q18›Q16

ICD-10-CM Q16.4
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

Q16.4 is a billable ICD-10-CM diagnosis code for other congenital malformations of middle ear. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 154 through 156. The code is exempt from POA reporting. Coders also document this condition as congenital anomaly of middle ear. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Congenital malformations of eye, ear, face, neck.

Code Identity

ICD-10-CM Code
Q16.4
Billable Status
Yes — Valid for Submission
Code Describes
Other congenital malformations of middle ear
Short Description
Other congenital malformations of middle ear
Same as the full description in the CMS dataset.
Parent Code
Q16
Congenital malformations of ear causing impairment of hearing

Code Classification

ChapterQ00-Q99Congenital malformations, deformations and chromosomal abnormalities
SectionQ10-Q18Congenital malformations of eye, ear, face and neck
CategoryQ16Congenital malformations of ear causing impairment of hearing
This CodeQ16.4Other congenital malformations of middle ear

Present on Admission (POA)Billing

Q16.4 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Congenital malformations of eye, ear, face and neck (Q10-Q18).

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Congenital anomaly of middle ear
  • Congenital malformation of left middle ear
  • Congenital malformation of right middle ear

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to Q16.4: its own notes plus those printed at Q16, block Q10-Q18, and Chapter 17. A note printed at a category, block or chapter applies to every code under it.

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • Congenital malformation of middle ear NOS

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From Q16 Congenital malformations of ear causing impairment of hearing applies to 7 codes
  • congenital deafness (H90.-)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Block Q10-Q18 Congenital malformations of eye, ear, face and neck applies to 62 codes
  • cleft lip and cleft palate (Q35-Q37)
  • congenital malformation of cervical spine (Q05.0, Q05.5, Q67.5, Q76.0-Q76.4)
  • congenital malformation of larynx (Q31.-)
  • congenital malformation of lip NEC (Q38.0)
  • congenital malformation of nose (Q30.-)
  • congenital malformation of parathyroid gland (Q89.2)
  • congenital malformation of thyroid gland (Q89.2)
From Chapter 17 (Q00-QA1) Congenital malformations, deformations and chromosomal abnormalities applies to 900 codes
  • inborn errors of metabolism (E70-E88)

Notes

General instructions on how these codes are used.

From Chapter 17 (Q00-QA1) Congenital malformations, deformations and chromosomal abnormalities applies to 900 codes
  • Codes from this chapter are not for use on maternal records

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name Q16.4, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming Q16.4: they are not reported together with it, unless the two conditions are unrelated.

  • Q17 Other congenital malformations of ear
    congenital malformations of ear with impairment of hearing (Q16.0-Q16.9) names Q16.0-Q16.9, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR MAL005
Congenital malformations of eye, ear, face, neck
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Birth Defects

A birth defect is a problem that happens while a baby is developing in the mother's body. Most birth defects happen during the first 3 months of pregnancy. One out of every 33 babies in the United States is born with a birth defect.

The full article covers:

  • What are birth defects?
  • What causes birth defects?
  • Who is at risk of having a baby with birth defects?
  • How are birth defects diagnosed?
  • What are the treatments for birth defects?
  • Can birth defects be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert Q16.4 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
744.03 Middle ear anomaly NEC
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About Q16.4Overview

What is the ICD-10 code for other congenital malformations of middle ear?

The ICD-10-CM code for other congenital malformations of middle ear is Q16.4 (sometimes written as Q164). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is Q16.4 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report other congenital malformations of middle ear on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does Q16.4 group to?

When other congenital malformations of middle ear is the principal diagnosis on an inpatient stay, it groups to MS-DRG 156, 155, 154, with relative weights from 0.6656 to 1.5916 depending on complications. Higher weights mean higher Medicare reimbursement.

Is Q16.4 exempt from POA reporting?

Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for other congenital malformations of middle ear on inpatient claims. The code appears in the Congenital malformations of eye, ear, face and neck (Q10-Q18) range of the CMS exempt list.

Can Q16.4 be reported with a code from H90?

Not as a rule. The Excludes1 note at Q16, which applies to Q16.4, lists "congenital deafness (H90.-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).