Q10-Q18
Medium Complexity
Congenital malformations of eye, ear, face and neck
Primary Specialty: Pediatrics
Last Updated: 2025-09-10
ICD-10 Codes (63)
55 billable0 category headers
Q11Q11.0Billable
Q11.1Billable
Q11.2Billable
Q11.3Billable
Q12Q12.0Billable
Q12.1Billable
Q12.2Billable
Q12.3Billable
Q12.4Billable
Q12.8Billable
Q12.9Billable
Q13Q13.0Billable
Q13.1Billable
Q13.2Billable
Q13.3Billable
Q13.4Billable
Q13.5Billable
Q13.8Billable
Q13.81Billable
Q13.89Billable
Q13.9Billable
Q14Q14.0Billable
Q14.1Billable
Q14.2Billable
Q14.3Billable
Q14.8Billable
Q14.9Billable
Q15Q15.0Billable
Q15.8Billable
Q15.9Billable
Q16Q16.0Billable
Q16.1Billable
Q16.2Billable
Q16.3Billable
Q16.4Billable
Q16.5Billable
Q16.9Billable
Q17Q17.0Billable
Q17.1Billable
Q17.2Billable
Q17.3Billable
Q17.4Billable
Q17.5Billable
Q17.8Billable
Q17.9Billable
Q18Q18.0Billable
Q18.1Billable
Q18.2Billable
Q18.3Billable
Q18.4Billable
Q18.5Billable
Q18.6Billable
Q18.7Billable
Q18.8Billable
Q18.9Billable
Updates & Changes
FY 2026 Updates
Current Year
New Codes (1)
Q23.4
Hypoplastic left heart syndrome with mitral atresia
Revised Codes (1)
Q21.0
Ventricular septal defect - updated to include hemodynamic significance when known
Deleted Codes
No codes deleted in this range for FY 2026
Historical Changes
- •FY 2025: Routine maintenance updates with minor terminology clarifications
- •FY 2024: Enhanced specificity requirements for certain code ranges
- •FY 2023: Updated documentation guidelines for improved clarity
Upcoming Changes
- •Proposed updates pending review by Coordination and Maintenance Committee
- •Under consideration: Enhanced digital health integration codes
Implementation Guidance
- •Review all FY 2026 updates for Q10-Q18 codes before implementation
- •Always verify the most current codes in the ICD-10-CM manual
- •Ensure clinical documentation supports the selected diagnosis codes
- +3 more guidance items...
Range Overview
high priority
The Q10-Q18 category in ICD-10 represents congenital malformations of the eye, ear, face, and neck. These codes are used to document birth defects and anomalies in these areas, present from birth. This range includes a variety of conditions, from minor malformations to severe deformities, impacting the patient's vision, hearing, facial appearance, and neck function.
Key Usage Points:
- •Always confirm the specific type of malformation before coding.
- •Use additional codes to identify any associated conditions or complications.
- •Understand the difference between malformations (present at birth) and deformities (developed later).
- •Remember to code for laterality when applicable.
- •Ensure to document any surgical corrections or ongoing treatments.
Coding Guidelines
When to Use:
- ✓When a patient presents with a congenital malformation of the eye.
- ✓When a patient has a congenital malformation of the ear affecting hearing.
- ✓In cases of congenital facial deformities.
- ✓When a patient has a congenital malformation of the neck.
- ✓When documenting a patient's medical history of congenital malformations.
When NOT to Use:
- ✗When the malformation was not present at birth.
- ✗When the malformation is not in the eye, ear, face, or neck.
- ✗When the malformation has been completely corrected surgically.
- ✗When the condition is a result of trauma or injury.
- ✗When the condition is due to a disease or disorder developed later in life.
Code Exclusions
Always verify exclusions with the patient's medical history and the physician's documentation.
Documentation Requirements
Accurate documentation is crucial for coding congenital malformations of the eye, ear, face, and neck. The documentation should clearly specify the type of malformation, its location, and any associated conditions or complications.
Clinical Information:
- •Specific type and location of the malformation.
- •Any associated conditions or complications.
- •Laterality, if applicable.
- •Any surgical corrections or ongoing treatments.
- •Confirmation that the malformation is congenital.
Supporting Evidence:
- •Medical history records.
- •Physical examination findings.
- •Imaging studies, if applicable.
- •Surgical reports, if applicable.
Good Documentation Example:
Patient has a congenital malformation of the right ear, specifically anotia, affecting hearing. No surgical correction has been done.
Poor Documentation Example:
Patient has a problem with the right ear.
Common Documentation Errors:
- âš Not specifying the type of malformation.
- âš Not documenting the location of the malformation.
- âš Not confirming that the malformation is congenital.
- âš Not coding for laterality when applicable.
Range Statistics
9
Total Codes
55
Billable
Complexity:
Medium
Primary Use:Clinical Documentation
Chapter:17
Coding Complexity
Medium
Complexity Rating
Coding for congenital malformations of the eye, ear, face, and neck can be moderately complex due to the need to accurately identify the specific type and location of the malformation, any associated conditions or complications, and the need to confirm that the malformation is congenital.
Key Factors:
- â–¸Understanding the specific type of malformation.
- â–¸Determining the correct location of the malformation.
- â–¸Identifying any associated conditions or complications.
- â–¸Coding for laterality when applicable.
- â–¸Confirming that the malformation is congenital.
Specialty Focus
These codes are commonly used in pediatrics, otolaryngology, and ophthalmology. They are crucial for documenting congenital malformations, guiding treatment plans, and tracking patient outcomes.
Primary Specialties:
Pediatrics
40%
Otolaryngology
30%
Ophthalmology
30%
Clinical Scenarios:
- • A newborn diagnosed with a congenital cleft lip.
- • A child with a congenital malformation of the ear affecting hearing.
- • A patient with a congenital malformation of the eye causing vision problems.
- • A patient with a congenital malformation of the neck causing functional issues.
- • A patient with a history of congenital facial malformations that have been surgically corrected.
Resources & References
Several resources are available for coding congenital malformations of the eye, ear, face, and neck. These include the official ICD-10 guidelines, coding clinic advice, and various clinical references.
Official Guidelines:
- ICD-10-CM Official Guidelines for Coding and Reporting
- AHA Coding Clinic for ICD-10-CM and ICD-10-PCS
- National Center for Health Statistics (NCHS) ICD-10 guidelines
Clinical References:
- American Academy of Pediatrics guidelines
- American Academy of Otolaryngology–Head and Neck Surgery guidelines
- American Academy of Ophthalmology guidelines
Educational Materials:
- AAPC ICD-10 training materials
- AHIMA ICD-10 coding resources
- CMS ICD-10 coding resources
Frequently Asked Questions
Can I use these codes for acquired deformities?
No, the Q10-Q18 category is specifically for congenital malformations. For acquired deformities, use codes from the M20-M27 range.