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Q11 ICD-10-CM Code: Anophthalmos, microphthalmos and macrophthalmos

Q11 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC Buddy coding tools

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FY 2026 Apr update / Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0) / Congenital malformations of eye, ear, face and neck (Q10-Q18)

Q11

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

Anophthalmos, microphthalmos and macrophthalmos

Anophthalmos, microphthalmos and macrophthalmos

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
Q1Congenital malformations of eye, ear, face and neck (Q10-Q18)
Q11Anophthalmos, microphthalmos and macrophthalmos

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for Q11 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for Q11 in this effective period.

Related Child Codes

Official
Q11.0Cystic eyeball
Q11.1Other anophthalmos
Q11.2Microphthalmos
Q11.3Macrophthalmos

Includes

Official

ICD-10-CM does not list Includes notes for Q11 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for Q11 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for Q11 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for Q11 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for Q11 in this effective period.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Code
Q11
Description
Anophthalmos, microphthalmos and macrophthalmos
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

Q11 is the ICD-10-CM diagnosis code for anophthalmos, microphthalmos and macrophthalmos. Q11 sits in the ICD-10-CM chapter for congenital malformations, deformations and chromosomal abnormalities (q00-qa0), within the section covering congenital malformations of eye, ear, face and neck (q10-q18).

Header codes like Q11 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 Q11'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 Q11 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

Q11Anophthalmos, microphthalmos and macrophthalmos
Q11Anophthalmos, microphthalmos and macrophthalmos

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