Q13.2

Q13.2: Other congenital malformations of iris

Billable / specific codeICD-10-CMPOA exempt

Q13.2 is a billable, specific ICD-10-CM code for other congenital malformations of iris. It is valid for submission on a claim.

Check Q13.2 with the rest of the claim: free scrubber

Inclusion terms

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

Anisocoria, congenital
Atresia of pupil
Congenital malformation of iris NOS
Corectopia

Other codes that can never be billed with Q13.2

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

H21.5Other and unspecified adhesions and disruptions of iris and ciliary body
H21.56Pupillary abnormalities

Risk adjustment

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

Medicare coverage

Q13.2 is named in 5 Medicare coverage policies: 5 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
A56615Billing and Coding: Cataract Extraction (including Complex Cataract Surgery)
A57483Billing and Coding: Visual Fields

Alphabetic index entries that lead here

Corectopia
Heterochromia(congenital)
Notch of iris
Polycoria
Anisocoria›congenital
Anomaly, anomalous›iris
Anomaly, anomalous›opticociliary vessels
Anomaly, anomalous›pupil
Atresia, atretic›pupil
Deformity›opticociliary vessels(congenital)
Deformity›pupil(congenital)
Malformation›iris

Code history

Unchanged in every release from FY2024 to FY2027.