Q04.9
Q04.9: Congenital malformation of brain, unspecified
Billable / specific codeICD-10-CMPOA exempt
Q04.9 is a billable, specific ICD-10-CM code for congenital malformation of brain, unspecified. It is valid for submission on a claim.
Check Q04.9 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Congenital anomaly NOS of brain
- Congenital deformity NOS of brain
- Congenital disease or lesion NOS of brain
- Multiple anomalies NOS of brain, congenital
Risk adjustment
Q04.9 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
Q04.9 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
- A56612Billing and Coding: CT of the Head
Alphabetic index entries that lead here
- Cyclencephaly
- Anomaly, anomalous›brain(multiple)
- Anomaly, anomalous›cerebral
- Anomaly, anomalous›dura(brain)
- Deformity›brain(congenital)
- Distortion›brain
- Malformation›brain(multiple)
- Malformation›cerebral
- Deformity›cerebral, acquired›congenital
- Disease, diseased›brain›congenital
- Lesion›brain›congenital
- Malformation›dura›brain
Code history
Unchanged in every release from FY2024 to FY2027.