Q06.3: Other congenital cauda equina malformations

Risk adjustment

Q06.3 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

Q06.3 is named in 6 Medicare coverage policies: 6 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

• A54095Billing and Coding: Nerve Conduction Studies and Electromyography
• A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
• A56612Billing and Coding: CT of the Head
• A57123Billing and Coding: Nerve Conduction Studies and Electromyography