Q64.2 ICD-10-CM Code: Congenital posterior urethral valves
HCC Buddy Code Card
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FY 2026 Apr update / Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0) / Congenital malformations of the urinary system (Q60-Q64)
Q64.2
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCongenital posterior urethral valves
A birth defect where abnormal tissue folds form in the urethra behind the bladder, blocking urine flow.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for Q64.2 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for Q64.2 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Q64.2 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for Q64.2 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Q64.2 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Q64.2 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Q64.2 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is Q64.2 an HCC code?
No. Q64.2 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- Q64.2
- Description
- Congenital posterior urethral valves
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Q64.2 is the ICD-10-CM diagnosis code for congenital posterior urethral valves. A birth defect where abnormal tissue folds form in the urethra behind the bladder, blocking urine flow. Q64.2 sits in the ICD-10-CM chapter for congenital malformations, deformations and chromosomal abnormalities (q00-qa0), within the section covering congenital malformations of the urinary system (q60-q64).
Q64.2 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
These valves are embryologic remnants that obstruct the posterior urethra in males.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Q64.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •These valves are embryologic remnants that obstruct the posterior urethra in males
- •Document whether unilateral or bilateral obstruction is present if applicable