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

ICD-10 Q87.0

Billable / Specific

Congenital malformation syndromes predominantly affecting facial appearance

Q87
Block
9
Synonyms
185
LCDs
7
Payer Policies
0
Linked CPTs

About ICD-10-CM Q87.0

ICD-10-CM code Q87.0 represents Congenital malformation syndromes predominantly affecting facial appearance. This is a billable/specific code in the Congenital Malformations chapter (block Q87). The 2026 edition of ICD-10-CM Q87.0 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under Q87.0. Per CMS ICD-10-CM Tabular 2026.

  • Acrocephalopolysyndactyly
  • Acrocephalosyndactyly [Apert]
  • Cryptophthalmos syndrome
  • Cyclopia
  • Goldenhar syndrome
  • Moebius syndrome
  • Oro-facial-digital syndrome
  • Robin syndrome
  • Whistling face

Medicare LCD Coverage for Q87.0

Local Coverage Determinations (LCDs) from CMS MACs that list Q87.0 as a covered diagnosis.

185 LCDs

Showing top 10 of 185 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Outpatient Occupational Therapy
Article ID: 53064, Effective: 2026-01-01 00:00:00, 8021 covered, 0 non-covered
CPT 29131 →
CMS LCD: Billing and Coding: Outpatient Occupational Therapy
Article ID: 53064, Effective: 2026-01-01 00:00:00, 8021 covered, 0 non-covered
CPT 29260 →
CMS LCD: Billing and Coding: Outpatient Occupational Therapy
Article ID: 53064, Effective: 2026-01-01 00:00:00, 8021 covered, 0 non-covered
CPT 97129 →
CMS LCD: Billing and Coding: Outpatient Occupational Therapy
Article ID: 53064, Effective: 2026-01-01 00:00:00, 8021 covered, 0 non-covered
CPT 97036 →
CMS LCD: Billing and Coding: Outpatient Occupational Therapy
Article ID: 53064, Effective: 2026-01-01 00:00:00, 8021 covered, 0 non-covered
CPT 97542 →
CMS LCD: Billing and Coding: Outpatient Occupational Therapy
Article ID: 53064, Effective: 2026-01-01 00:00:00, 8021 covered, 0 non-covered
CPT 97110 →
CMS LCD: Billing and Coding: Outpatient Occupational Therapy
Article ID: 53064, Effective: 2026-01-01 00:00:00, 8021 covered, 0 non-covered
CPT 97533 →
CMS LCD: Billing and Coding: Outpatient Occupational Therapy
Article ID: 53064, Effective: 2026-01-01 00:00:00, 8021 covered, 0 non-covered
CPT 29130 →
CMS LCD: Billing and Coding: Outpatient Occupational Therapy
Article ID: 53064, Effective: 2026-01-01 00:00:00, 8021 covered, 0 non-covered
CPT 29405 →
CMS LCD: Billing and Coding: Outpatient Occupational Therapy
Article ID: 53064, Effective: 2026-01-01 00:00:00, 8021 covered, 0 non-covered
CPT 92610 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing Q87.0.

7 policies

2 Aetna

Orthopedic Casts, Braces and Splints - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0009
Distraction Osteogenesis for Craniofacial Defects
Policy ID: CPB-0549

1 Cigna

Anesthesia Services for Interventional Pain Management Procedures in an Adult - (0551)
Policy ID: MM_0551

4 Medicare

Billing and Coding: Home Health Occupational Therapy
Policy ID: ART-53057
Billing and Coding: Outpatient Occupational Therapy
Policy ID: ART-53064
Billing and Coding: CT of the Head
Policy ID: ART-56612
Billing and Coding: MRI and CT Scans of the Head and Neck
Policy ID: ART-57204

CPT Codes Commonly Billed with Q87.0

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

No procedure linkages on file for Q87.0

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 Q87.0 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
Q87.0 75555 10000
Q87.0 7560 10000

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

ICD-10 Q87.0, Billing FAQ

Is ICD-10 code Q87.0 billable? +

Yes, Q87.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to Q87.0? +

ICD-10 Q87.0 includes: Acrocephalopolysyndactyly; Acrocephalosyndactyly [Apert]; Cryptophthalmos syndrome, and 6 more clinical synonyms.

What ICD-9 codes does Q87.0 map to? +

Per CMS GEMs, Q87.0 maps to ICD-9 codes: 75555, 7560. 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 July 16, 2026.

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