Q12 ICD-10-CM Code: Congenital lens malformations
Q12 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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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)
Q12
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceCongenital lens malformations
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
Inclusion Terms
OfficialNo inclusion terms are included in this display for Q12. Check the code and parent instructions in the Code Book.
Excludes 2
Official- inborn errors of metabolism (E70-E88)Inherited from Q00-QA0, Q10-Q18
- cleft lip and cleft palate (Q35-Q37)Inherited from Q00-QA0, Q10-Q18
- congenital malformation of cervical spine (Q05.0, Q05.5, Q67.5, Q76.0-Q76.4)Inherited from Q00-QA0, Q10-Q18
- congenital malformation of larynx (Q31.-)Inherited from Q00-QA0, Q10-Q18
- congenital malformation of lip NEC (Q38.0)Inherited from Q00-QA0, Q10-Q18
- congenital malformation of nose (Q30.-)Inherited from Q00-QA0, Q10-Q18
- congenital malformation of parathyroid gland (Q89.2)Inherited from Q00-QA0, Q10-Q18
- congenital malformation of thyroid gland (Q89.2)Inherited from Q00-QA0, Q10-Q18
Related Codes
Includes
OfficialNo Includes notes are included in this display for Q12. Check the code and parent instructions in the Code Book.
Excludes 1
OfficialNo Excludes 1 notes are included in this display for Q12. Check the code and parent instructions in the Code Book.
Code First
OfficialNo Code First sequencing instructions are included in this display for Q12. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for Q12. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for Q12. Check the code and parent instructions in the Code Book.
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
- Q12
- Description
- Congenital lens malformations
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- No
- Payment year
- 2026
Coder workflow notes
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What This Code Means
Q12 is the ICD-10-CM diagnosis code for congenital lens malformations. Q12 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 Q12 cannot be reported on claims directly; they organize child codes that share clinical context. Coders should select the billable child code that matches the documented presentation and then verify its current source-backed HCC mapping. Do not infer a child code or risk adjustment value from the header alone.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for Q12 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.