ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 Q10.0

Billable / Specific

Congenital ptosis

Q10
Block
0
Synonyms
141
LCDs
13
Payer Policies
10
Linked CPTs

About ICD-10-CM Q10.0

ICD-10-CM code Q10.0 represents Congenital ptosis. This is a billable/specific code in the Congenital Malformations chapter (block Q10). The 2026 edition of ICD-10-CM Q10.0 became effective on October 1, 2025.

Medicare LCD Coverage for Q10.0

Local Coverage Determinations (LCDs) from CMS MACs that list Q10.0 as a covered diagnosis.

141 LCDs

Showing top 10 of 141 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92524 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 96112 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92521 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97130 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97129 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92597 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97110 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97533 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 96110 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92522 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing Q10.0.

13 policies

2 Aetna

Eyelid Surgery - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0084
External Ocular Photography
Policy ID: CPB-0734

5 Medicare

Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Policy ID: ART-54111
Billing and Coding: Blepharoplasty
Policy ID: ART-56439
Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift
Policy ID: ART-56503
Billing and Coding: Visual Fields Testing
Policy ID: ART-56551
Billing and Coding: Visual Fields Testing
Policy ID: ART-56799

CPT Codes Commonly Billed with Q10.0

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

10 linkages
  • 67906 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD
  • 67908 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD
  • 67902 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD
  • 15823 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD
  • 67901 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD
  • 67904 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD
  • 67903 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD
  • 67900 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD
  • 15822 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD
  • 67909 CMS LCD: Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift CMS LCD

Convert Q10.0 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
Q10.0 74361 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 Q10.0, Billing FAQ

Is ICD-10 code Q10.0 billable? +

Yes, Q10.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with Q10.0? +

Procedures frequently paired with Q10.0 include: 67906, 67908, 67902, 15823, 67901.

What ICD-9 codes does Q10.0 map to? +

Per CMS GEMs, Q10.0 maps to ICD-9 codes: 74361. 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 June 1, 2026.

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