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ICD-10 Guide
ICD-10 CodesChapter 17: Congenital malformations and chromosomal abnormalitiesQ76

Q76

Non-billable

Congenital malformations of spine and bony thorax

Chapter 17:Congenital malformations and chromosomal abnormalities

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 Q76 is a used to indicate a diagnosis of congenital malformations of spine and bony thorax.

Key Diagnostic Point:

The ICD-10 Level 1 Category code Q76 encompasses congenital malformations of the spine and bony thorax, which are structural abnormalities present at birth. These conditions can include a variety of deformities such as scoliosis, kyphosis, spina bifida, and other vertebral anomalies. The clinical significance of these malformations is profound, as they can lead to functional impairments, chronic pain, and may require surgical intervention or ongoing management. Early diagnosis and treatment are crucial to improve outcomes and quality of life for affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation
  • Need for multidisciplinary management
  • Potential for surgical intervention

Audit Risk Factors

  • Inadequate documentation of specific malformations
  • Misclassification of severity
  • Failure to capture associated conditions

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Orthopedics

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical and administrative impact of the Q76 code category is significant, as it directly relates to the management of congenital conditions that can affect a patient's overall health and quality of life. Accurate coding can influence quality measures and population health statistics, as these conditions often require long-term management and multidisciplinary care. Additionally, as healthcare trends move towards value-based care, understanding the implications of congenital malformations on patient outcomes is essential for improving healthcare delivery and resource allocation.

ICD-9 vs ICD-10

The clinical and administrative impact of the Q76 code category is significant, as it directly relates to the management of congenital conditions that can affect a patient's overall health and quality of life. Accurate coding can influence quality measures and population health statistics, as these conditions often require long-term management and multidisciplinary care. Additionally, as healthcare trends move towards value-based care, understanding the implications of congenital malformations on patient outcomes is essential for improving healthcare delivery and resource allocation.

Reimbursement & Billing Impact

reimbursement. Providers should ensure that all relevant clinical information is included in the medical record, as this will support the medical necessity of the procedures performed. Common practices include using modifiers to indicate the complexity of the case and ensuring that pre-authorization is obtained when necessary for surgical interventions.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for Q76

Coding & Billing References

  • •
    Official ICD-10 Guidelines for Q76

Frequently Asked Questions

What conditions are included in Q76?

Q76 includes a variety of congenital malformations such as spina bifida, scoliosis, kyphosis, and other vertebral anomalies that affect the structure of the spine and thoracic cavity.

When should I use Q76 codes?

Q76 codes should be used when documenting congenital malformations of the spine and bony thorax that are identified at birth or during early childhood, particularly when these conditions impact the patient's health and require medical intervention.

What documentation is required for Q76?

Documentation for Q76 should include a detailed description of the malformation, any associated symptoms, diagnostic imaging results, and the treatment plan. It is essential to provide clear clinical notes that justify the use of the specific Q76 code.