Q11.1 — Other anophthalmos
Q11.1 is a billable, specific ICD-10-CM code for other anophthalmos. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Anophthalmos NOS
- Agenesis of eye
- Aplasia of eye
Risk adjustment
Q11.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
Q11.1 is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
- A56439Billing and Coding: Blepharoplasty
- A56908Billing and Coding: Blepharoplasty, Blepharoptosis and Brow Lift
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
How Q11.1 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 Q11.1.
- Anophthalmos, anophthalmus(congenital) (globe)
- Agenesis›eye
- Aplasia›eye
- Absence›eye›congenital
- Absence›globe›congenital
Related codes at this level
Codes that share Q11. If Q11.1 is not quite right, the correct code is usually one of these.
Questions about Q11.1
- Is Q11.1 a billable ICD-10-CM code?
- Yes. Q11.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Q11.1 sit in the tabular list?
- Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Congenital malformations of eye, ear, face and neck (Q10-Q18).