Q12 ICD-10-CM Code: Congenital lens malformations
Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.
Coding at a Glance
- Tabular directives
- 7 Excludes2
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for Q12 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025
Notes without a marker are published on Q12 itself; “inherited from” names the category or block whose note applies here.
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- cleft lip and cleft palate (Q35-Q37) Compare Q12 vs Q35 →
- congenital malformation of cervical spine (Q05.0, Q05.5, Q67.5, Q76.0-Q76.4) Compare Q12 vs Q05.0 →
- congenital malformation of larynx (Q31.-) Compare Q12 vs Q31 →
- congenital malformation of lip NEC (Q38.0) Compare Q12 vs Q38.0 →
- congenital malformation of nose (Q30.-) Compare Q12 vs Q30 →
- congenital malformation of parathyroid gland (Q89.2) Compare Q12 vs Q89.2 →
- congenital malformation of thyroid gland (Q89.2) Compare Q12 vs Q89.2 →
Source: inherited from Q10-Q18
Coder workflow for Q12
MedCoder structured workflow — derived from this code’s own official record
Before you code Q12
- Q12 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).
ReviewQ12.0, Q12.1, Q12.2, Q12.3, Q12.4, Q12.8, Q12.9
See the relationships section · Guide: How to choose an ICD-10-CM code →
Choose the right path
- Does the documentation support one of the more specific codes beneath Q12?
Yes → Select that code and continue the checks below on its own page.
No → Q12 cannot be reported as written; query for the specificity its subcategory needs.
Consider Q12. Then confirm the code is valid for the date of service in the Verify section.
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).
Official instructions as workflow
Excludes2 — not part of Q12(7 notes)
Coding workflow: The conditions named in this note are not included in Q12. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
CompareQ05.0, Q05.5, Q67.5, Q31, Q38.0, Q30
See the official tabular notes · Guidelines I.A.12.b
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.
Code Overview
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
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 structured relationships — computed from published CMS and AHRQ datasets
Other codes that name Q12 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.
Referenced by 1 Excludes1 note: H27 — Other disorders of lens.
These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.
Contextual Map
Every relationship of Q12 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.
Run Q12 with these 9 related codes in Claim Check
Hierarchy
- Q00-QA1 — Chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-QA1) (Q00-QA1)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- Q10-Q18 — Congenital malformations of eye, ear, face and neck[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Excludes2 (11)
- Q05.0 — Cervical spina bifida with hydrocephalus[Excludes2]: “congenital malformation of cervical spine (Q05.0, Q05.5, Q67.5, Q76.0-Q76.4)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- Q05.5 — Cervical spina bifida without hydrocephalus[Excludes2]: “congenital malformation of cervical spine (Q05.0, Q05.5, Q67.5, Q76.0-Q76.4)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- Q30 — Congenital malformations of nose[Excludes2]: “congenital malformation of nose (Q30.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- Q31 — Congenital malformations of larynx[Excludes2]: “congenital malformation of larynx (Q31.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- Q35 — Cleft palate[Excludes2]: “cleft lip and cleft palate (Q35-Q37)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- Q36 — Cleft lip[Excludes2]: “cleft lip and cleft palate (Q35-Q37)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- Q37 — Cleft palate with cleft lip[Excludes2]: “cleft lip and cleft palate (Q35-Q37)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- Q38.0 — Congenital malformations of lips, not elsewhere classified[Excludes2]: “congenital malformation of lip NEC (Q38.0)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- and 3 more
Referenced by Excludes1 notes
- H27 — Other disorders of lens[Excludes1]: “congenital lens malformations (Q12.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Nearest codes
- Q12.0 — Congenital cataract[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- Q12.1 — Congenital displaced lens[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- Q12.2 — Coloboma of lens[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- Q12.3 — Congenital aphakia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- Q12.4 — Spherophakia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- Q12.8 — Other congenital lens malformations[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- Q12.9 — Congenital lens malformation, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Common coding questions
Can Q12 be billed directly?
No. Q12 (Congenital lens malformations) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.
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 FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) 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 structured 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 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.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
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. "Q12 — Congenital lens malformations." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/q12-congenital-lens-malformations
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionCongenital lens malformations
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), 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 Q12 in its code family, with their registry titles.