Q04.6: Congenital cerebral cysts
Q04.6 is a billable, specific ICD-10-CM code for congenital cerebral cysts. It is valid for submission on a claim.
Check Q04.6 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- acquired porencephalic cyst (G93.0)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Porencephaly
- Schizencephaly
Other codes that can never be billed with Q04.6
Their own Excludes1 notes name this code, so the conflict is not listed above.
- G93.0Cerebral cysts
Risk adjustment
Q04.6 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
Q04.6 is named in 3 Medicare coverage policies: 3 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
- A56612Billing and Coding: CT of the Head
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
Alphabetic index entries that lead here
- Porencephaly(congenital) (developmental) (true)
- Schizencephaly
- Cyst›paraphysis, cerebri, congenital
- Cyst›porencephalic
- Cyst›arachnoid, brain›congenital
- Cyst›brain›congenital
- Cyst›brain›third ventricle, congenital(colloid)
- Cyst›choroid plexus›congenital
- Degeneration, degenerative›brain›cystic›congenital
Code history
Unchanged in every release from FY2024 to FY2027.