Is ICD-10-CM code Q05 billable?

No, Q05 (Spina bifida) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code Q05 belong to?

Q05 belongs to Chapter 17 of the ICD-10-CM tabular list: Q00–Q99 (Congenital Malformations, Deformations and Chromosomal Abnormalities).

Q05Not billable, use a more specific code below

Spina bifida

In Congenital malformations of the nervous system (Q00-Q07), chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities

10 billable codes under Q05: 5 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.

Instructional notes

Includes: conditions that are coded here

hydromeningocele (spinal)
meningocele (spinal)
meningomyelocele
myelocele
myelomeningocele
rachischisis
spina bifida (aperta)(cystica)
syringomyelocele

Excludes1: not coded here, use a different code

Arnold-Chiari syndrome, type II (Q07.0-)
spina bifida occulta (Q76.0)

Use additional code: add a second code for this, listed after this one

code for any associated paraplegia (paraparesis) (G82.2-)

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.

Read Section I.C.17 (page 74)

All codes under Q05

Q05 can't be used on a claim. Pick a billable code below; grey headings group them.

Q05 MS-DRGs

As the principal diagnosis, all 10 billable codes under Q05 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 Q05

Notes on these codes point to Q05.

G91 Excludes1: spina bifida with hydrocephalus (Q05.-)
Q76.0 Excludes1: meningocele (spinal) (Q05.-)
Q76.0 Excludes1: spina bifida (aperta) (cystica) (Q05.-)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Spina Bifida

Spina bifida is a neural tube defect - a type of birth defect of the brain, spine, or spinal cord. It happens if the spinal column of the fetus doesn't close completely during the first month of pregnancy. This can damage the nerves and spinal cord. Screening tests during pregnancy can check for spina bifida. Sometimes it is discovered only after the baby is born.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.