Q12.3
Q12.3: Congenital aphakia
Billable / specific codeICD-10-CMPOA exempt
Q12.3 is a billable, specific ICD-10-CM code for congenital aphakia. It is valid for submission on a claim.
Check Q12.3 with the rest of the claim: free scrubberOther codes that can never be billed with Q12.3
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
Q12.3 is named in 8 Medicare coverage policies: 8 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52499Refractive Lenses - Policy Article
- A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
- A56453Billing and Coding: Cataract Extraction
- A56544Billing and Coding: Cataract Extraction
Alphabetic index entries that lead here
- Agenesis›lens
- Aphakia›congenital
- Absence›lens›congenital
Code history
Unchanged in every release from FY2024 to FY2027.