ICD-10 · PDGM grouping
Q64 Other congenital malformations of urinary system
All 22 codes in the Q64 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
22
Can lead a claim
20
Cannot lead a claim
2
What CMS assigns to Q64
20 of the 22 codes group to MMTA - Other; 2 are assigned no clinical group. None of the 22 is assigned a comorbidity subgroup. 20 of the 22 can lead a claim.
Every code in Q64
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| Q64.0 | Epispadias | Can lead a claim | A | None |
| Q64.1 Exstrophy of urinary bladder | ||||
| Q64.10 | Exstrophy of urinary bladder, unspecified | Can lead a claim | A | None |
| Q64.11 | Supravesical fissure of urinary bladder | Can lead a claim | A | None |
| Q64.12 | Cloacal exstrophy of urinary bladder | Can lead a claim | A | None |
| Q64.19 | Other exstrophy of urinary bladder | Can lead a claim | A | None |
| Q64.2 | Congenital posterior urethral valves | Can lead a claim | A | None |
| Q64.3 Other atresia and stenosis of urethra and bladder neck | ||||
| Q64.31 | Congenital bladder neck obstruction | Can lead a claim | A | None |
| Q64.32 | Congenital stricture of urethra | Can lead a claim | A | None |
| Q64.33 | Congenital stricture of urinary meatus | Can lead a claim | A | None |
| Q64.39 | Other atresia and stenosis of urethra and bladder neck | Can lead a claim | A | None |
| Q64.4 | Malformation of urachus | Can lead a claim | A | None |
| Q64.5 | Congenital absence of bladder and urethra | Can lead a claim | A | None |
| Q64.6 | Congenital diverticulum of bladder | Can lead a claim | A | None |
| Q64.7 Other and unspecified congenital malformations of bladder and urethra | ||||
| Q64.70 | Unspecified congenital malformation of bladder and urethra | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Q64.71 | Congenital prolapse of urethra | Can lead a claim | A | None |
| Q64.72 | Congenital prolapse of urinary meatus | Can lead a claim | A | None |
| Q64.73 | Congenital urethrorectal fistula | Can lead a claim | A | None |
| Q64.74 | Double urethra | Can lead a claim | A | None |
| Q64.75 | Double urinary meatus | Can lead a claim | A | None |
| Q64.79 | Other congenital malformations of bladder and urethra | Can lead a claim | A | None |
| Q64.8 | Other specified congenital malformations of urinary system | Can lead a claim | A | None |
| Q64.9 | Congenital malformation of urinary system, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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