Is ICD-10-CM code Q11 billable?

No, Q11 (Anophthalmos, microphthalmos and macrophthalmos) 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 Q11 belong to?

Q11 belongs to Chapter 17 of the ICD-10-CM tabular list: Q00–Q99 (Congenital Malformations, Deformations and Chromosomal Abnormalities).

Q11Not billable, use a more specific code below

Anophthalmos, microphthalmos and macrophthalmos

In Congenital malformations of eye, ear, face and neck (Q10-Q18), chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities

4 billable codes under Q11: none are a CC or MCC; none map to an HCC.

Instructional notes

Also applies, from Congenital malformations of eye, ear, face and neck (Q10-Q18)

These notes sit on Q10-Q18 and apply to every code under it, including Q11.

Excludes2: not included here, code separately if applicable

cleft lip and cleft palate (Q35-Q37)
congenital malformation of cervical spine (Q05.0, Q05.5, Q67.5, Q76.0-Q76.4)
congenital malformation of larynx (Q31.-)
congenital malformation of lip NEC (Q38.0)
congenital malformation of nose (Q30.-)
congenital malformation of parathyroid gland (Q89.2)
congenital malformation of thyroid gland (Q89.2)

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 Q11

Q11 can't be used on a claim. Pick a billable code below; grey headings group them.

Q11 MS-DRGs

As the principal diagnosis, all 4 billable codes under Q11 group to MS-DRG 124 or 125 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

About the condition

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

Birth Defects

A birth defect is a problem that happens while a baby is developing in the mother's body. Most birth defects happen during the first 3 months of pregnancy. One out of every 33 babies in the United States is born with a birth defect.

Eye Diseases

Even if your eyes feel healthy, you could have a problem and not know it. That's why regular eye exams are so important. Refractive errors are the most common type of vision problem that makes it hard to see clearly. But some eye conditions or diseases don't have any symptoms and can lead to a permanent loss of vision.

Code history

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