ICD-10 Q76.426
Billable / Specific CCCongenital lordosis, lumbar region
About ICD-10-CM Q76.426
ICD-10-CM code Q76.426 represents Congenital lordosis, lumbar region. This is a billable/specific code in the Congenital Malformations chapter (block Q76). The 2026 edition of ICD-10-CM Q76.426 became effective on October 1, 2025.
Coding Tips for Q76.426
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
Q76.426 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inpatient DRG Impact, CC
codes Congenital lordosis, lumbar region. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for Q76.426
Local Coverage Determinations (LCDs) from CMS MACs that list Q76.426 as a covered diagnosis.
Showing top 8. Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Q76.426.
1 Cigna
2 Medicare
CPT Codes Commonly Billed with Q76.426
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 Q76.426 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 |
|---|---|---|
| Q76.426 | 7542 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To Q76.426
Other codes in section Q65-Q79 (Congenital malformations and deformations of the musculoskeletal system).
ICD-10 Q76.426, Billing FAQ
Is ICD-10 code Q76.426 billable? +
Yes, Q76.426 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is Q76.426 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What ICD-9 codes does Q76.426 map to? +
Per CMS GEMs, Q76.426 maps to ICD-9 codes: 7542. 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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