Q14.1

Q14.1: Congenital malformation of retina

Billable / specific codeICD-10-CMPOA exempt

Q14.1 is a billable, specific ICD-10-CM code for congenital malformation of retina. It is valid for submission on a claim.

Check Q14.1 with the rest of the claim: free scrubber

Inclusion terms

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

Congenital retinal aneurysm

Excludes2 inherited from the categories above Q14.1

Not part of this code, but both may be coded when both are present.

Written on Q14: Congenital malformations of posterior segment of eye

optic nerve hypoplasia (H47.03-)

Other codes that can never be billed with Q14.1

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

H33.1Retinoschisis and retinal cysts

Risk adjustment

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

Medicare coverage

Q14.1 is named in 8 Medicare coverage policies: 8 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
A56551Billing and Coding: Visual Fields Testing
A56726Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)

Alphabetic index entries that lead here

Anomaly, anomalous›fovea centralis
Anomaly, anomalous›retina
Aplasia›fovea centralis(congenital)
Displacement, displaced›macula(congenital)
Dysplasia›retinal, congenital
Malformation›retina
Medullated fibers›retina
Pigmentation›retina, congenital(grouped) (nevoid)
Retinoschisis›congenital
Tortuous›retinal vessel, congenital
Aberrant›artery›retina
Aneurysm›congenital›retina

Code history

Unchanged in every release from FY2024 to FY2027.