Is Q76.428 a billable ICD-10-CM code?

Yes. Q76.428 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Q76.428 sit in the tabular list?

Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Congenital malformations and deformations of the musculoskeletal system (Q65-Q79).

What cannot be coded together with Q76.428?

Q76.428 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Q76.428 (Q76) and apply to it just the same.

Q76.428

Q76.428 — Congenital lordosis, sacral and sacrococcygeal region

Billable / specific codeICD-10-CMPOA exempt

Q76.428 is a billable, specific ICD-10-CM code for congenital lordosis, sacral and sacrococcygeal region. It is valid for submission on a claim.

Excludes1 inherited from the categories above Q76.428

These are not written on Q76.428, but they bind it: a note on a category applies to every code beneath it. Billing Q76.428 with anything listed here is a denial.

Written on Q76 — Congenital malformations of spine and bony thorax

congenital musculoskeletal deformities of spine and chest (Q67.5-Q67.8)

Risk adjustment

Q76.428 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

Q76.428 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57206Billing and Coding: Lumbar MRI

How Q76.428 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 Q76.428.

Lordosis›congenital›sacral region
Lordosis›congenital›sacrococcygeal region

Code history

Q76.428 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share Q76.42. If Q76.428 is not quite right, the correct code is usually one of these.

Questions about Q76.428

Is Q76.428 a billable ICD-10-CM code?: Yes. Q76.428 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Q76.428 sit in the tabular list?: Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Congenital malformations and deformations of the musculoskeletal system (Q65-Q79).
What cannot be coded together with Q76.428?: Q76.428 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Q76.428 (Q76) and apply to it just the same.