Q38.7
Billable codeCongenital pharyngeal pouch
The ICD-10 code for congenital pharyngeal pouch is Q38.7.
Clinical notes
Excludes1 (not coded here)
An Excludes1 note is a pure exclusion: the excluded condition and this code should never be reported together, because the two conditions cannot occur at the same time (e.g. a congenital form vs. an acquired form of the same disease).
- pharyngeal pouch syndrome (D82.1)
Also known as
Alternate wording, synonyms, or specific conditions that fall under this code, listed to help confirm you've picked the right one.
- Congenital diverticulum of pharynx
Documentation support
General coding-documentation guidance — not a substitute for payer-specific requirements or professional coding judgment.
- •Confirm the excluded condition(s) listed above are not also present — Excludes1 conditions cannot be coded together with this one.
- •As a general rule, code to the highest level of specificity supported by the documentation in the medical record.
Related codes in this category
- Q38.0Congenital malformations of lips, not elsewhere classified
- Q38.1Ankyloglossia
- Q38.2Macroglossia
- Q38.3Other congenital malformations of tongue
- Q38.4Congenital malformations of salivary glands and ducts
- Q38.5Congenital malformations of palate, not elsewhere classified
- Q38.6Other congenital malformations of mouth
- Q38.8Other congenital malformations of pharynx
- Q38.7Congenital pharyngeal pouch
ICD-9-CM equivalent
Informational only — GEM mappings are approximate, not guaranteed one-to-one equivalents. Verify before use in billing.
- 75027
Associated MS-DRGs
Q38.7 can serve as the principal diagnosis for these Medicare Severity Diagnosis-Related Groups.
Informational only — actual DRG assignment also depends on procedures, complications/comorbidities (CC/MCC), discharge status, and payer-specific rules not reflected here.
- DRG 011Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCC
- DRG 012Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CC
- DRG 013Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCC
- DRG 154Other Ear, Nose, Mouth and Throat Diagnoses with MCC
- DRG 155Other Ear, Nose, Mouth and Throat Diagnoses with CC
- DRG 156Other Ear, Nose, Mouth and Throat Diagnoses without CC/MCC