Encephalocele
In Congenital malformations of the nervous system (Q00-Q07), chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities
5 billable codes under Q01: all are a CC; all map to HCC 182 (Spinal Cord Disorders/Injuries).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.
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Instructional notes
Includes: conditions that are coded here
- Arnold-Chiari syndrome, type III
- encephalocystocele
- encephalomyelocele
- hydroencephalocele
- hydromeningocele, cranial
- meningocele, cerebral
- meningoencephalocele
Excludes1: not coded here, use a different code
- Meckel-Gruber syndrome (Q61.9)
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
Assign Q00-QA1 codes for documented congenital anomalies or genetic disorders at any age, coding non-inherent manifestations separately and sequencing Z38 first on the birth admission.
All codes under Q01
Q01 can't be used on a claim. Pick a billable code below; grey headings group them.
Q01 MS-DRGs
As the principal diagnosis, all 5 billable codes under Q01 group to MS-DRG 091, 092, 093, 791, or 793 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
Other codes that refer to Q01
Notes on these codes point to Q01.
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Neural Tube Defects
Neural tube defects are birth defects of the brain, spine, or spinal cord. They happen in the first month of pregnancy, often before a woman even knows that she is pregnant. The two most common neural tube defects are spina bifida and anencephaly. In spina bifida, the fetal spinal column doesn't close completely. There is usually nerve damage that causes at least some paralysis of the legs. In anencephaly, most of the brain and skull do not develop. Babies with anencephaly are usually either stillborn or die shortly after birth. Another type of defect, Chiari malformation, causes the brain tissue to extend into the spinal canal.
Read more about neural tube defects on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.