Q87.5 — Other congenital malformation syndromes with other skeletal changes
Q87.5 is a billable, specific ICD-10-CM code for other congenital malformation syndromes with other skeletal changes. It is valid for submission on a claim.
Risk adjustment
Q87.5 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
Q87.5 is named in 4 Medicare coverage policies — 4 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
- A56726Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
- A57071Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
How Q87.5 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 Q87.5.
- Malformation›affecting multiple systems with skeletal changes NEC
Related codes at this level
Codes that share Q87. If Q87.5 is not quite right, the correct code is usually one of these.
- Q87.0Congenital malformation syndromes predominantly affecting facial appearance
- Q87.1Congenital malformation syndromes predominantly associated with short stature
- Q87.2Congenital malformation syndromes predominantly involving limbs
- Q87.3Congenital malformation syndromes involving early overgrowth
- Q87.4Marfan syndrome
- Q87.8Other specified congenital malformation syndromes, not elsewhere classified
Questions about Q87.5
- Is Q87.5 a billable ICD-10-CM code?
- Yes. Q87.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Q87.5 sit in the tabular list?
- Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0), in the block Other congenital malformations (Q80-Q89).