Q10.4

Q10.4: Absence and agenesis of lacrimal apparatus

Billable / specific codeICD-10-CMPOA exempt

Q10.4 is a billable, specific ICD-10-CM code for absence and agenesis of lacrimal apparatus. It is valid for submission on a claim.

Check Q10.4 with the rest of the claim: free scrubber

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Congenital absence of punctum lacrimale

Excludes1 inherited from the categories above Q10.4

A category’s note binds every code beneath it.

Written on Q10: Congenital malformations of eyelid, lacrimal apparatus and orbit

cryptophthalmos NOS (Q11.2)
cryptophthalmos syndrome (Q87.0)

Other codes that can never be billed with Q10.4

Their own Excludes1 notes name this code, so the conflict is not listed above.

H04Disorders of lacrimal system

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

Q10.4 is named in 4 Medicare coverage policies: 4 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
A57483Billing and Coding: Visual Fields
A57637Billing and Coding: Visual Field Examination

Alphabetic index entries that lead here

Absence›canaliculus lacrimalis, congenital
Absence›punctum lacrimale(congenital)
Agenesis›canaliculus lacrimalis
Agenesis›lacrimal apparatus
Agenesis›punctum lacrimale
Atresia, atretic›lacrimal apparatus

Code history

Unchanged in every release from FY2024 to FY2027.