2026 ICD-10-CM Diagnosis Code Q38.7Congenital pharyngeal pouch
ICD-10-CM Codes›Q00-Q99›Q38-Q45›Q38
- Billable — Valid for Submission
- POA Exempt
- Chronic Condition
Q38.7 is a billable ICD-10-CM diagnosis code for congenital pharyngeal pouch. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 11 through 13, 154 through 156. The code is exempt from POA reporting. Coders also document this condition as congenital diverticulum of pharynx. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Digestive congenital anomalies.
Code Identity
Code Classification
Present on Admission (POA)Billing
Q38.7 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Other congenital malformations of the digestive system (Q38-Q45).
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Congenital diverticulum of pharynx
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Congenital diverticulum of pharynx
Type 1 Excludes
- pharyngeal pouch syndrome D82.1
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
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.
Patient EducationClinical
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Read the full article at MedlinePlus
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Convert Q38.7 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Q38.7Overview
What is the ICD-10 code for congenital pharyngeal pouch?
The ICD-10-CM code for congenital pharyngeal pouch is Q38.7 (sometimes written as Q387). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is Q38.7 (Other congenital malformations of tongue, mouth and pharynx) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report congenital pharyngeal pouch on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does Q38.7 group to?
When congenital pharyngeal pouch is the principal diagnosis on an inpatient stay, it groups to MS-DRG 11, 12, 13, 154, 155, 156, with relative weights from 0.6911 to 5.4541 depending on complications. Higher weights mean higher Medicare reimbursement.
Is Q38.7 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 congenital pharyngeal pouch on inpatient claims. The code appears in the Other congenital malformations of the digestive system (Q38-Q45) range of the CMS exempt list.
What is the ICD-9 equivalent of Q38.7?
Under the General Equivalence Mappings, congenital pharyngeal pouch converts to ICD-9-CM 750.27 (diverticulum of pharynx). The mapping is a direct match.
