ICD-10 Q02
Billable / Specific HCC v28: 72Microcephaly
About ICD-10-CM Q02
ICD-10-CM code Q02 represents Microcephaly. This is a billable/specific code in the Congenital Malformations chapter (block Q02). The 2026 edition of ICD-10-CM Q02 became effective on October 1, 2025.
Coding Tips for Q02
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
Q02 is a CMS-HCC v28 risk-adjustment code (category 72). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
Type 1 Excludes
Pure excludes, these codes can never be coded together with Q02. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- Meckel-Gruber syndrome (Q61.9)
Includes
- hydromicrocephaly
- micrencephalon
Coding Notes
Code First
- , if applicable, congenital Zika virus disease
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Medicare LCD Coverage for Q02
Local Coverage Determinations (LCDs) from CMS MACs that list Q02 as a covered diagnosis.
Showing top 10 of 61 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Q02.
2 Cigna
3 Medicare
CPT Codes Commonly Billed with Q02
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert Q02 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| Q02 | 7421 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To Q02
Other codes in section Q00-Q07 (Congenital malformations of the nervous system).
ICD-10 Q02, Billing FAQ
Is ICD-10 code Q02 billable? +
Yes, Q02 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What codes are Type 1 Excludes for Q02? +
Type 1 Excludes (never code together with Q02): Meckel-Gruber syndrome (Q61.9)
Does Q02 affect Medicare Advantage HCC risk adjustment? +
Yes. Q02 maps to CMS-HCC v28 category 72. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does Q02 map to? +
Per CMS GEMs, Q02 maps to ICD-9 codes: 7421. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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