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ICD-10 Guide
ICD-10 CodesChapter 17: Congenital malformations and chromosomal abnormalitiesQ75

Q75

Billable

Other congenital malformations of skull and face bones

Chapter 17:Congenital malformations and chromosomal abnormalities

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

Code Description

ICD-10 Q75 is a billable code used to indicate a diagnosis of other congenital malformations of skull and face bones.

Key Diagnostic Point:

Congenital malformations of the skull and face bones encompass a variety of structural anomalies that can affect the shape and function of the craniofacial region. These malformations may arise from genetic factors, environmental influences, or a combination of both during fetal development. Conditions such as craniosynostosis, where one or more of the sutures in an infant's skull close prematurely, can lead to abnormal head shapes and potential neurological issues. Other examples include facial clefts, which can affect the lip and palate, and various syndromic conditions that involve craniofacial dysmorphisms. The clinical presentation can vary widely, necessitating a multidisciplinary approach for management, including surgical intervention, orthodontic treatment, and ongoing developmental support. Accurate coding of these conditions is crucial for appropriate treatment planning and resource allocation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of conditions
  • Need for detailed clinical documentation to support coding
  • Potential overlap with other congenital codes
  • Requirement for knowledge of associated syndromes

Audit Risk Factors

  • Inadequate documentation of the specific malformation
  • Failure to link the diagnosis to treatment provided
  • Misclassification of the type of malformation
  • Lack of supporting evidence for associated syndromes

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation should include detailed descriptions of the malformation, associated symptoms, and any interventions performed. Growth and developmental assessments are also critical.

Common Clinical Scenarios

Common scenarios include infants presenting with abnormal head shapes, children with cleft lip/palate requiring surgical repair, and ongoing assessments for developmental milestones.

Billing Considerations

Consideration must be given to the age of the patient, as some conditions may evolve over time, impacting coding accuracy.

Genetics

Documentation Requirements

Genetic documentation should include family history, genetic testing results, and any syndromic associations that may influence treatment.

Common Clinical Scenarios

Scenarios include genetic counseling for families with a history of craniofacial anomalies and the identification of syndromes such as Apert or Crouzon syndrome.

Billing Considerations

Genetic coding requires an understanding of the implications of chromosomal abnormalities and their potential impact on craniofacial development.

Coding Guidelines

Inclusion Criteria

Use Q75 When
  • Follow the official ICD
  • CM coding guidelines for congenital conditions, ensuring that the documentation supports the diagnosis
  • Use additional codes for associated conditions or complications as necessary

Exclusion Criteria

Do NOT use Q75 When
No specific exclusions found.

Related CPT Codes

15732CPT Code

Craniofacial reconstruction

Clinical Scenario

Used in cases of craniosynostosis or significant craniofacial deformities.

Documentation Requirements

Detailed operative reports and pre-operative assessments.

Specialty Considerations

Pediatric surgeons must document the specific malformations addressed during surgery.

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.

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.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the key considerations when coding congenital malformations?

Key considerations include ensuring accurate documentation of the specific malformation, understanding associated syndromes, and linking diagnoses to treatments provided. Coders should also stay updated on coding guidelines and changes.