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Q12 ICD-10-CM Code: Congenital lens malformations

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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 guidance

Congenital lens malformations

Congenital lens malformations

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

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Code Book Path

Official
Q1Congenital malformations of eye, ear, face and neck (Q10-Q18)
Q12Congenital lens malformations

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for Q12 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for Q12 in this effective period.

Related Child Codes

Official
Q12.0Congenital cataract
Q12.1Congenital displaced lens
Q12.2Coloboma of lens
Q12.3Congenital aphakia
Q12.4Spherophakia

Includes

Official

ICD-10-CM does not list Includes notes for Q12 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for Q12 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for Q12 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for Q12 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for Q12 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

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 but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at Q12'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 Q12 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

Q12Congenital lens malformations
Q12Congenital lens malformations

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