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ICD-10 Guide
ICD-10 CodesQ01.1

Q01.1

Billable

Nasofrontal encephalocele

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

Code Description

ICD-10 Q01.1 is a billable code used to indicate a diagnosis of nasofrontal encephalocele.

Key Diagnostic Point:

Nasofrontal encephalocele is a type of congenital malformation characterized by a protrusion of brain tissue and meninges through a defect in the frontal bone, typically located in the nasofrontal region. This condition arises during embryonic development when the neural tube fails to close properly, leading to abnormal brain and skull formation. Patients may present with a visible mass on the forehead or nose, which can be associated with other neurological deficits or craniofacial anomalies. The severity of the condition can vary significantly, with some infants experiencing mild symptoms while others may have severe neurological impairments. Diagnosis is usually made through imaging studies such as MRI or CT scans, which help delineate the extent of the encephalocele and any associated brain malformations. Surgical intervention is often required to repair the defect and to address any associated complications, such as hydrocephalus or infections. Early diagnosis and management are crucial for improving outcomes in affected infants.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of the condition
  • Need for detailed imaging reports for accurate coding
  • Potential for co-occurring congenital anomalies
  • Documentation of surgical interventions and follow-up care

Audit Risk Factors

  • Inadequate documentation of associated anomalies
  • Failure to capture surgical procedures performed
  • Misclassification of encephalocele type
  • Lack of detailed imaging reports in the medical record

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation must include detailed growth and developmental assessments, imaging results, and surgical notes.

Common Clinical Scenarios

Common scenarios include newborns presenting with a mass on the forehead, infants with developmental delays, and cases requiring multidisciplinary care.

Billing Considerations

Accurate coding requires awareness of the potential for associated conditions such as hydrocephalus and craniofacial syndromes.

Genetics

Documentation Requirements

Genetic documentation should include family history, genetic testing results, and any syndromic associations.

Common Clinical Scenarios

Scenarios may involve genetic counseling for families with a history of congenital malformations or syndromes.

Billing Considerations

Consideration of chromosomal abnormalities that may co-occur with nasofrontal encephalocele is essential for accurate coding.

Coding Guidelines

Inclusion Criteria

Use Q01.1 When
  • Follow official ICD
  • CM guidelines for coding congenital malformations, ensuring accurate documentation of the condition's severity, associated anomalies, and any surgical interventions performed

Exclusion Criteria

Do NOT use Q01.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

61510CPT Code

Cranial vault reconstruction

Clinical Scenario

Used in cases of nasofrontal encephalocele requiring surgical intervention.

Documentation Requirements

Detailed operative notes and pre-operative imaging.

Specialty Considerations

Pediatric neurosurgery documentation must include indications for surgery and post-operative care.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital malformations, improving the accuracy of data collection and reimbursement processes for conditions like nasofrontal encephalocele.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital malformations, improving the accuracy of data collection and reimbursement processes for conditions like nasofrontal encephalocele.

Reimbursement & Billing Impact

reimbursement processes for conditions like nasofrontal encephalocele.

Resources

Clinical References

  • •
    CDC Congenital Malformations

Coding & Billing References

  • •
    CDC Congenital Malformations

Frequently Asked Questions

What is the prognosis for a child with nasofrontal encephalocele?

The prognosis varies widely depending on the size of the encephalocele and associated neurological deficits. Early surgical intervention can improve outcomes, but long-term follow-up is essential to monitor for developmental delays and other complications.