Q00.1: Craniorachischisis

Risk adjustment

Q00.1 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

• HCC 182 Spinal Cord Disorders/Injuries0.478 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

Q00.1 is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

• A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
• A57204Billing and Coding: MRI and CT Scans of the Head and Neck