Is Q13.5 a billable ICD-10-CM code?

Yes. Q13.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Q13.5 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).

Q13.5

Q13.5 — Blue sclera

Billable / specific codeICD-10-CMPOA exempt

Q13.5 is a billable, specific ICD-10-CM code for blue sclera. It is valid for submission on a claim.

Risk adjustment

Q13.5 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

Q13.5 is named in 2 Medicare coverage policies — 2 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
A57483Billing and Coding: Visual Fields

How Q13.5 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 Q13.5.

Blue›sclera
Imperfect›closure›sclera

Related codes at this level

Codes that share Q13. If Q13.5 is not quite right, the correct code is usually one of these.

Questions about Q13.5

Is Q13.5 a billable ICD-10-CM code?: Yes. Q13.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Q13.5 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).