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ICD-10 Guide
ICD-10 CodesQ85.8

Q85.8

Billable

Other phakomatoses, not elsewhere classified

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 Q85.8 is a billable code used to indicate a diagnosis of other phakomatoses, not elsewhere classified.

Key Diagnostic Point:

Phakomatoses are a group of congenital disorders characterized by the presence of skin lesions and other abnormalities that can affect multiple organ systems. The term 'phakomatosis' derives from the Greek word 'phakos,' meaning 'spot' or 'blemish,' and these conditions often involve neurocutaneous syndromes. Q85.8 encompasses various rare congenital malformations that do not fit neatly into other classifications. These may include conditions such as nevus sebaceous, which can lead to secondary complications like basal cell carcinoma, or other skin lesions associated with systemic abnormalities. Additionally, congenital malformations of the breast, spleen, and adrenal glands may also be classified under this code when they present in conjunction with skin lesions or other neurocutaneous manifestations. Accurate diagnosis and coding require a thorough understanding of the clinical presentation, as well as the potential for associated syndromic features, which can complicate management and treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of associated congenital conditions
  • Overlap with other congenital codes
  • Need for detailed clinical documentation
  • Potential for misclassification

Audit Risk Factors

  • Inadequate documentation of associated conditions
  • Misuse of the code for non-congenital conditions
  • Failure to specify the type of phakomatosis
  • Inconsistent clinical findings

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation must include growth parameters, developmental milestones, and detailed descriptions of skin lesions and associated symptoms.

Common Clinical Scenarios

Common scenarios include a pediatric patient presenting with café-au-lait spots and developmental delays, necessitating a thorough evaluation for neurofibromatosis or other syndromes.

Billing Considerations

Consideration of family history and genetic predisposition is crucial in pediatric cases, as many phakomatoses have hereditary components.

Genetics

Documentation Requirements

Genetic documentation should include results from genetic testing, family pedigree analysis, and any syndromic associations identified during evaluation.

Common Clinical Scenarios

Genetic counseling scenarios often involve families with a history of neurocutaneous syndromes, where genetic testing can confirm diagnoses and guide management.

Billing Considerations

Genetic coders must be aware of the implications of chromosomal abnormalities that may co-occur with phakomatoses, as these can influence treatment and prognosis.

Coding Guidelines

Inclusion Criteria

Use Q85.8 When
  • Official coding guidelines for congenital and chromosomal conditions emphasize the importance of specificity in documentation, including the need to report any associated congenital anomalies or syndromic features that may influence treatment

Exclusion Criteria

Do NOT use Q85.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits for management of congenital skin lesions.

Documentation Requirements

Documentation must include history, examination findings, and treatment plan.

Specialty Considerations

Pediatricians should ensure developmental assessments are included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the ability to capture the complexity of phakomatoses and their associated anomalies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the ability to capture the complexity of phakomatoses and their associated anomalies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the ability to capture the complexity of phakomatoses and their associated anomalies.

Resources

Clinical References

  • •
    American Academy of Pediatrics Coding Resources

Coding & Billing References

  • •
    American Academy of Pediatrics Coding Resources

Frequently Asked Questions

What are the common conditions classified under Q85.8?

Common conditions include nevus sebaceous, other neurocutaneous syndromes, and various congenital skin lesions that do not fit into more specific categories.