ICD-10 Q05
Non-Billable HeaderSpina bifida
About ICD-10-CM Q05
ICD-10-CM code Q05 represents Spina bifida. This is a non-billable header code in the Congenital Malformations chapter (block Q05). The 2026 edition of ICD-10-CM Q05 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with Q05. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- Arnold-Chiari syndrome, type II (Q07.0-)
- spina bifida occulta (Q76.0)
Includes
- hydromeningocele (spinal)
- meningocele (spinal)
- meningomyelocele
- myelocele
- myelomeningocele
- rachischisis
- spina bifida (aperta)(cystica)
- syringomyelocele
Use Additional Code
When coding Q05, also report these additional codes when applicable.
- code for any associated paraplegia (paraparesis) (G82.2-)
Medicare LCD Coverage for Q05
Local Coverage Determinations (LCDs) from CMS MACs that list Q05 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Q05.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but Q05 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with Q05
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.
Codes Adjacent To Q05
Other codes in section Q00-Q07 (Congenital malformations of the nervous system).
ICD-10 Q05, Billing FAQ
Is ICD-10 code Q05 billable? +
No, Q05 is a non-billable header code. Use a more specific child code from block Q05 when submitting claims.
What codes are Type 1 Excludes for Q05? +
Type 1 Excludes (never code together with Q05): Arnold-Chiari syndrome, type II (Q07.0-); spina bifida occulta (Q76.0)
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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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