Q05.1 — Thoracic spina bifida with hydrocephalus
Q05.1 is a billable, specific ICD-10-CM code for thoracic spina bifida with hydrocephalus. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Dorsal spina bifida with hydrocephalus
- Thoracolumbar spina bifida with hydrocephalus
Risk adjustment
Q05.1 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.
Medicare coverage
Q05.1 is named in 16 Medicare coverage policies — 16 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A54095Billing and Coding: Nerve Conduction Studies and Electromyography
- A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
- A54969Billing and Coding: Nerve Conduction Studies and Electromyography
- A56619Billing and Coding: Nerve Conduction Studies and Electromyography
How Q05.1 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to Q05.1.
- Spina bifida›dorsal›with hydrocephalus
- Spina bifida›thoracic›with hydrocephalus
- Spina bifida›thoracolumbar›with hydrocephalus
- Hydrocephalus›congenital›with spina bifida›dorsal
- Hydrocephalus›congenital›with spina bifida›thoracic
- Hydrocephalus›congenital›with spina bifida›thoracolumbar
Related codes at this level
Codes that share Q05. If Q05.1 is not quite right, the correct code is usually one of these.
- Q05.0Cervical spina bifida with hydrocephalus
- Q05.2Lumbar spina bifida with hydrocephalus
- Q05.3Sacral spina bifida with hydrocephalus
- Q05.4Unspecified spina bifida with hydrocephalus
- Q05.5Cervical spina bifida without hydrocephalus
- Q05.6Thoracic spina bifida without hydrocephalus
- Q05.7Lumbar spina bifida without hydrocephalus
- Q05.8Sacral spina bifida without hydrocephalus
- Q05.9Spina bifida, unspecified
Questions about Q05.1
- Is Q05.1 a billable ICD-10-CM code?
- Yes. Q05.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Q05.1 sit in the tabular list?
- Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Congenital malformations of the nervous system (Q00-Q07).