ICD-10 Q64
Non-Billable HeaderOther congenital malformations of urinary system
About ICD-10-CM Q64
ICD-10-CM code Q64 represents Other congenital malformations of urinary system. This is a non-billable header code in the Congenital Malformations chapter (block Q64). The 2026 edition of ICD-10-CM Q64 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Medicare LCD Coverage for Q64
Local Coverage Determinations (LCDs) from CMS MACs that list Q64 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Q64.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but Q64 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with Q64
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To Q64
Other codes in section Q60-Q64 (Congenital malformations of the urinary system).
ICD-10 Q64, Billing FAQ
Is ICD-10 code Q64 billable? +
No, Q64 is a non-billable header code. Use a more specific child code from block Q64 when submitting claims.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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