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Q05 ICD-10-CM Code: Spina bifida

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FY 2026 Apr update / Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0) / Congenital malformations of the nervous system (Q00-Q07)

Q05

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Spina bifida

Spina bifida

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
Q0Congenital malformations of the nervous system (Q00-Q07)
Q05Spina bifida

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for Q05 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for Q05 in this effective period.

Related Child Codes

Official
Q05.0Cervical spina bifida with hydrocephalus
Q05.1Thoracic spina bifida with hydrocephalus
Q05.2Lumbar spina bifida with hydrocephalus
Q05.3Sacral spina bifida with hydrocephalus
Q05.4Unspecified spina bifida with hydrocephalus

Includes

Official
  • hydromeningocele (spinal)
  • meningocele (spinal)
  • meningomyelocele
  • myelocele
  • myelomeningocele

Excludes 1

Official
  • Arnold-Chiari syndrome, type II (Q07.0-)
  • spina bifida occulta (Q76.0)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for Q05 in this effective period.

Use Additional

Official
  • code for any associated paraplegia (paraparesis) (G82.2-)

Code Also

Official

ICD-10-CM does not list Code Also instructions for Q05 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

Q05 is the ICD-10-CM diagnosis code for spina bifida. Q05 sits in the ICD-10-CM chapter for congenital malformations, deformations and chromosomal abnormalities (q00-qa0), within the section covering congenital malformations of the nervous system (q00-q07).

Header codes like Q05 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at Q05's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Q05 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Includes

  • hydromeningocele (spinal)
  • meningocele (spinal)
  • meningomyelocele
  • myelocele
  • myelomeningocele
  • rachischisis
  • spina bifida (aperta)(cystica)
  • syringomyelocele

Excludes 1, Do NOT code together

  • Arnold-Chiari syndrome, type II (Q07.0-)
  • spina bifida occulta (Q76.0)

Use Additional Code

  • code for any associated paraplegia (paraparesis) (G82.2-)

Child Codes

Code Hierarchy

Q05Spina bifida
Q05Spina bifida

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