Q05.1
BillableThoracic spina bifida with hydrocephalus
HCC Category Mapping
V28HCC 182 — Spinal Cord Disorders/Injuries
0.282V24HCC 72 — Spinal Cord Disorders/Injuries
0.464ESRDHCC 72 — Spinal Cord Disorders/Injuries
0.000RxHCCHCC 155 — Myelitis and Encephalomyelitis
0.000What This Code Means
A birth defect where the spine doesn't close properly in the upper back area, combined with fluid buildup in the brain (hydrocephalus).
Coding Tips
- •Verify documentation confirms thoracic (upper back) location of the spina bifida
- •Ensure hydrocephalus is also documented; use Q05.6 if hydrocephalus is absent
Clinical Significance
Thoracic spina bifida with hydrocephalus is a complex congenital malformation affecting the mid-spine region with associated brain fluid accumulation. This condition requires intensive medical management, often involving multiple surgical interventions and ongoing neurological monitoring throughout the patient's lifetime.
Documentation Requirements
- ✓Specific thoracic vertebral levels affected by spina bifida
- ✓Hydrocephalus severity with current ventricular measurements
- ✓Neurological deficits including motor and sensory function assessment
- ✓Respiratory function status given thoracic location
- ✓Bowel and bladder control status and management
- ✓Shunt presence, type, and functional status
- ✓Mobility aids and orthotic device requirements
- ✓Multidisciplinary team involvement and current interventions
Commonly Confused Codes
Q051 vs Q050 — Q050 affects cervical spine, Q051 affects thoracic spineQ051 vs Q052 — Q052 affects lumbar spine, not thoracicQ051 vs Q760 — Q760 is occult spina bifida without hydrocephalusQ051 vs Q913 — Q913 is hydrocephalus alone without spina bifidaQ051 vs G826 — G826 is acquired flaccid tetraplegia, not congenital
Code Hierarchy
└Q05Spina bifida└Q05.1Thoracic spina bifida with hydrocephalus
└Q05.1Thoracic spina bifida with hydrocephalus