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Q12.4

Q12.4: Spherophakia

Billable / specific codeICD-10-CMPOA exempt

Q12.4 is a billable, specific ICD-10-CM code for spherophakia. It is valid for submission on a claim.

Check Q12.4 with the rest of the claim: free scrubber

Other codes that can never be billed with Q12.4

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

  • H27Other disorders of lens

Risk adjustment

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

Medicare coverage

Q12.4 is named in 11 Medicare coverage policies: 11 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

  • A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
  • A56453Billing and Coding: Cataract Extraction
  • A56544Billing and Coding: Cataract Extraction
  • A56549Billing and Coding: Ophthalmic Biometry for Intraocular Lens Power Calculation

Alphabetic index entries that lead here

  • Sphericity, increased, lens(congenital)
  • Spherophakia
  • Increase, increased›sphericity, lens

Code history

Unchanged in every release from FY2024 to FY2027.

Other codes under Q12

ICD-10-CMFY2027· effective October 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release: see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.