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Q03.1

Billable

Atresia of foramina of Magendie and Luschka

HCC Category Mapping

V28HCC 182Spinal Cord Disorders/Injuries
0.282
V24HCC 72Spinal Cord Disorders/Injuries
0.464
ESRDHCC 72Spinal Cord Disorders/Injuries
0.000
RxHCCHCC 155Myelitis and Encephalomyelitis
0.000

What This Code Means

A birth defect where the small openings in the brain that allow fluid to flow are blocked or absent, preventing normal cerebrospinal fluid circulation.

Coding Tips

  • This is a specific type of congenital hydrocephalus; do not use Q03.9 if Q03.1 is confirmed
  • Document whether this is associated with other CNS malformations for complete coding

Clinical Significance

Atresia of the foramina of Magendie and Luschka causes severe obstructive hydrocephalus by blocking cerebrospinal fluid outflow from the fourth ventricle. This condition typically presents in infancy with macrocephaly and requires urgent neurosurgical intervention.

Documentation Requirements

  • Documentation of atresia (absence or closure) of foramina of Magendie and Luschka
  • Evidence of fourth ventricular obstruction and hydrocephalus
  • Neuroimaging confirming foramen atresia and ventricular dilation
  • Clinical presentation including macrocephaly or increased head circumference
  • Neurological examination findings
  • Documentation of surgical intervention needs or history
  • Assessment of developmental impact and prognosis
  • Ongoing care requirements and monitoring

Commonly Confused Codes

Code Hierarchy

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