Valid for Submission
Q64.0 is a billable code used to specify a medical diagnosis of epispadias. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Q64.0 might also be used to specify conditions or terms like epispadias or epispadias, female or epispadias, male or hypospadias and epispadias. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
Tabular List of Diseases and Injuries
The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code Q64.0:
Type 1 Excludes Type 1 Excludes
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 Injuries
The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code Q64.0 are found in the index:
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Epispadias, female
- Epispadias, male
- Hypospadias and epispadias
- EPISPADIAS-. a birth defect due to malformation of the urethra in which the urethral opening is above its normal location. in the male the malformed urethra generally opens on the top or the side of the penis but the urethra can also be open the entire length of the penis. in the female the malformed urethral opening is often between the clitoris and the labia or in the abdomen.
Diagnostic Related Groups
The ICD-10 code Q64.0 is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). applicable from 10/01/2019 through 09/30/2020.
- 729 - OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC
- 730 - OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC
Present on Admission (POA)
Q64.0 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here .
CMS POA Indicator Options and Definitions
|POA Indicator Code||POA Reason for Code||CMS will pay the CC/MCC DRG?|
|Y||Diagnosis was present at time of inpatient admission.||YES|
|N||Diagnosis was not present at time of inpatient admission.||NO|
|U||Documentation insufficient to determine if the condition was present at the time of inpatient admission.||NO|
|W||Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.||YES|
|1||Unreported/Not used - Exempt from POA reporting. ||NO|
Convert Q64.0 to ICD-9
Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
Congenital malformations of the urinary system (Q60-Q64)
Other congenital malformations of urinary system (Q64)
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
(First year ICD-10-CM implemented into the HIPAA code set)
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020