Q85.89 — Other phakomatoses, not elsewhere classified
Q85.89 is a billable, specific ICD-10-CM code for other phakomatoses, not elsewhere classified. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Peutz-Jeghers syndrome
- Sturge-Weber(-Dimitri) syndrome
Other codes that can never be billed with Q85.89
These codes carry an Excludes1 note pointing at Q85.89. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Q85.89 alone.
Risk adjustment
Q85.89 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 23 Prostate, Breast, and Other Cancers and Tumors0.186 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
Q85.89 is named in 11 Medicare coverage policies — 11 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
- A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
- A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
- A56461Billing and Coding: Endoscopy by Capsule
How Q85.89 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 Q85.89.
- Dimitri-Sturge-Weber disease
- Kraft-Weber-Dimitri disease
- Peutz-Jeghers disease or syndrome
- Sturge disease or syndrome(-Weber) (-Dimitri) (-Kalischer)
- Angiomatosis›encephalotrigeminal
- Phakomatosis›specified NEC
- Syndrome›Peutz-Jeghers
- Syndrome›Sturge-Weber(-Dimitri)
Related codes at this level
Codes that share Q85.8. If Q85.89 is not quite right, the correct code is usually one of these.
Questions about Q85.89
- Is Q85.89 a billable ICD-10-CM code?
- Yes. Q85.89 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Q85.89 sit in the tabular list?
- Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Other congenital malformations (Q80-Q89).