2026 ICD-10-CM Diagnosis Code Q64.0Epispadias

ICD-10-CM Codes›Q00-Q99›Q60-Q64›Q64

ICD-10-CM Q64.0
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Q64.0 is a billable ICD-10-CM diagnosis code for epispadias. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 729 through 730. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Genitourinary congenital anomalies.

Code Identity

ICD-10-CM Code
Q64.0
Billable Status
Yes — Valid for Submission
Code Describes
Epispadias
Short Description
Epispadias
Same as the full description in the CMS dataset.
Parent Code
Q64
Other congenital malformations of urinary system

Code Classification

ChapterQ00-Q99Congenital malformations, deformations and chromosomal abnormalities
SectionQ60-Q64Congenital malformations of the urinary system
CategoryQ64Other congenital malformations of urinary system
This CodeQ64.0Epispadias

Present on Admission (POA)Billing

Q64.0 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Epispadias
  • Exstrophy epispadias complex
  • Female epispadias
  • Male epispadias

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Type 1 Excludes

  • hypospadias Q54

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Epispadias(female) (male)

Clinical ClassificationClinical

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

CCSR MAL003
Genitourinary congenital anomalies
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • 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.

  • Continent Epispadias

    epispadias with urinary continence.

  • Epispadias

    a rare congenital abnormality that mostly affects males. in males, it is characterized by the presence of the urethral opening in the dorsal surface of the penis. in females, this abnormality is even rarer and is characterized by the presence of an elongated urethra that has developed too far anteriorly.

  • Incontinent Epispadias

    epispadias with urinary incontinence.

Patient EducationClinical

Urethral Disorders

The urethra is the tube that allows urine to pass out of the body. In men, it's a long tube that runs through the penis. It also carries semen in men. In women, it's short and is just above the vagina. Urethral problems may happen due to aging, illness, or injury. They include:

Read the full article at MedlinePlus

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

Convert Q64.0 to ICD-9-CMHistory

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

ICD-9-CM
752.62 Epispadias
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 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Q64.0Overview

Is Q64.0 (Other congenital malformations of urinary system) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report epispadias on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does Q64.0 group to?

When epispadias is the principal diagnosis on an inpatient stay, it groups to MS-DRG 729, 730, with relative weights from 0.6720 to 1.0587 depending on complications. Higher weights mean higher Medicare reimbursement.

Is Q64.0 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 epispadias on inpatient claims.

What is the ICD-9 equivalent of Q64.0?

Under the General Equivalence Mappings, epispadias converts to ICD-9-CM 752.62 (epispadias). The mapping is a direct match.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.