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Q06.3 ICD-10-CM Code: Other congenital cauda equina malformations

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Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 72 · RxHCC V08 category 155

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

The tabular list publishes no instructional note for this code itself.

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 091 — OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC (MDC 01)
  • MS-DRG 092 — OTHER DISORDERS OF NERVOUS SYSTEM WITH CC (MDC 01)
  • MS-DRG 093 — OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC (MDC 01)
  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 182 — Spinal Cord Disorders/Injuries

Other models: CMS-HCC V22 HCC 72 · RxHCC V08 HCC 155

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coder workflow for Q06.3

MedCoder structured workflow — derived from this code’s own official record

Before you code Q06.3

  1. “Other” (NEC) means the condition is specified in the record but no dedicated code captures it. Confirm the documented form is not one a sibling code names before settling on Q06.3; if the record states no specifics at all, the unspecified sibling applies instead. “Other” codes are for documented conditions the classification gives no specific code; “unspecified” codes are for records lacking the detail (Guidelines I.A.9.a, I.A.9.b).

    ReviewQ06.0, Q06.1, Q06.2, Q06.4

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse Q06.3 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of Q06.3 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • Q06.9— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Congenital malformation of spinal cord, unspecified” takes Q06.9; specificity in the record moves it back here.

    Full comparison: Q06.3 vs Q06.9 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Other congenital cauda equina malformations is a billable ICD-10-CM diagnosis code (Q06.3).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 5 MS-DRGs: DRG 091 (MDC 01), DRG 092 (MDC 01), DRG 093 (MDC 01), DRG 791 (MDC 15), DRG 793 (MDC 15).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):MAL004 — Nervous system congenital anomalies (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Spinal Cord Disorders/Injuries) for risk-adjusted payment.

Q05.3 — Sacral spina bifida with hydrocephalus, Q05.4 — Unspecified spina bifida with hydrocephalus, Q05.5 — Cervical spina bifida without hydrocephalus, Q05.6 — Thoracic spina bifida without hydrocephalus, Q05.7 — Lumbar spina bifida without hydrocephalus, Q05.8 — Sacral spina bifida without hydrocephalus, Q05.9 — Spina bifida, unspecified, Q06.0 — Amyelia, Q06.1 — Hypoplasia and dysplasia of spinal cord, Q06.2 — Diastematomyelia, Q06.4 — Hydromyelia, Q06.8 — Other specified congenital malformations of spinal cord, Q06.9 — Congenital malformation of spinal cord, unspecified, Q07.00 — Arnold-Chiari syndrome without spina bifida or hydrocephalus, Q07.01 — Arnold-Chiari syndrome with spina bifida, Q07.02 — Arnold-Chiari syndrome with hydrocephalus, Q07.03 — Arnold-Chiari syndrome with spina bifida and hydrocephalus, Q07.8 — Other specified congenital malformations of nervous system, Q07.9 — Congenital malformation of nervous system, unspecified, S14.0XXA — Concussion and edema of cervical spinal cord, initial encounter, +230 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Quadriplegia, Paraplegia

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Nervous system congenital anomalies).

Q05.3 — Sacral spina bifida with hydrocephalus, Q05.4 — Unspecified spina bifida with hydrocephalus, Q05.5 — Cervical spina bifida without hydrocephalus, Q05.6 — Thoracic spina bifida without hydrocephalus, Q05.7 — Lumbar spina bifida without hydrocephalus, Q05.8 — Sacral spina bifida without hydrocephalus, Q05.9 — Spina bifida, unspecified, Q06.0 — Amyelia, Q06.1 — Hypoplasia and dysplasia of spinal cord, Q06.2 — Diastematomyelia, Q06.4 — Hydromyelia, Q06.8 — Other specified congenital malformations of spinal cord, Q06.9 — Congenital malformation of spinal cord, unspecified, Q07.00 — Arnold-Chiari syndrome without spina bifida or hydrocephalus, Q07.01 — Arnold-Chiari syndrome with spina bifida, Q07.02 — Arnold-Chiari syndrome with hydrocephalus, Q07.03 — Arnold-Chiari syndrome with spina bifida and hydrocephalus, Q07.8 — Other specified congenital malformations of nervous system, Q07.9 — Congenital malformation of nervous system, unspecified, Q85.00 — Neurofibromatosis, unspecified, +29 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Anomaly, anomalous”, “Defect, defective”; these codes share that main term but sit in a different category of the Tabular List.

O99.13 — Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism complicating the puerperium (coagulation, postpartum), P61.6 — Other transient neonatal disorders of coagulation (coagulation, newborn, transient), P83.5 — Congenital hydrocele (genitalia, genital organor system, male, hydrocele), Q00.0 — Anencephaly (hemicrania), Q02 — Microcephaly (skull, with, microcephaly), Q03.0 — Malformations of aqueduct of Sylvius (aqueduct of Sylvius), Q03.9 — Congenital hydrocephalus, unspecified (skull, with, hydrocephalus), Q04.8 — Other specified congenital malformations of brain (meninges, cerebral), Q04.9 — Congenital malformation of brain, unspecified (dura), Q05.9 — Spina bifida, unspecified (meningocele), Q07.8 — Other specified congenital malformations of nervous system (optic, nerve), Q07.9 — Congenital malformation of nervous system, unspecified (gyri), Q10.0 — Congenital ptosis (eye, ptosis), Q10.3 — Other congenital malformations of eyelid (lid), Q10.6 — Other congenital malformations of lacrimal apparatus (caruncle, lacrimal), Q10.7 — Congenital malformation of orbit (orbit), Q12.9 — Congenital lens malformation, unspecified (lens), Q13.2 — Other congenital malformations of iris (iris), Q13.4 — Other congenital corneal malformations (cornea), Q13.81 — Rieger anomaly (Rieger), +350 more

Contextual Map

Every relationship of Q06.3 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 182 — Spinal Cord Disorders/Injuries [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • MDC 01 — Diseases and Disorders of the Nervous System[MDC crossing]: “Diseases and Disorders of the Nervous System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 8,919 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027
  • MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period[MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Anomaly, anomalous (congenital) (unspecified type), cauda equina[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Defect, defective, developmental, cauda equina[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Development, defective, congenital, cauda equina[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (3)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 20, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "Q06.3 — Other congenital cauda equina malformations." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/q06.3-other-congenital-cauda-equina-malformations

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Other congenital cauda equina malformations

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to Q06.3 in its code family, with their registry titles.

View all codes in the Q06 family