Question 1

What is ICD-10 code Q13.3?

Accepted Answer

Q13.3 is the ICD-10-CM diagnosis code for congenital corneal opacity. A birth defect where the cornea (the clear front part of the eye) is cloudy or opaque, which can impair vision from birth. Q13.3 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).

Q13.3 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Specify laterality and document the degree of opacity (partial or complete) if available.

Question 2

Is Q13.3 an HCC code?

Accepted Answer

Q13.3 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

Question 3

Is Q13.3 billable?

Accepted Answer

Yes. Q13.3 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. Q13.3 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

Which HCC does Q13.3 map to under V28?

Accepted Answer

Q13.3 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

Question 5

What RAF reference is published for Q13.3?

Accepted Answer

Q13.3 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

Question 6

What is the V28 vs V24 difference for Q13.3?

Accepted Answer

Q13.3 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

Question 7

What documentation supports Q13.3?

Accepted Answer

Specify laterality and document the degree of opacity (partial or complete) if available Note any associated conditions such as keratoconus or other corneal dystrophies Q13.3 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

Question 8

Can Q13.3 be a primary diagnosis?

Accepted Answer

Yes. Q13.3 carries no code-first instruction in the FY2026 tabular, so it can be the first-listed diagnosis when it is the condition chiefly responsible for the encounter and the note supports it, and it can also be reported as a secondary diagnosis. For risk adjustment the order does not matter; the V28 category is the same either way.

Question 9

Which codes cannot be reported with Q13.3?

Accepted Answer

No Excludes1 note applies to Q13.3 or its category in the FY2026 tabular, so there is no code the classification forbids alongside it. The Excludes2 note lists inborn errors of metabolism (E70-E88); cleft lip and cleft palate (Q35-Q37); congenital malformation of cervical spine (Q05.0, Q05.5, Q67.5, Q76.0-Q76.4); congenital malformation of larynx (Q31.-); and 4 more (see the notes on this page); those are separate conditions that may be reported together with Q13.3 when both are documented.

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Q13.3

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Q13.3 ICD-10-CM Code: Congenital corneal opacity

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Q13.3

Is Q13.3 an HCC code?

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Work Q13.3 in HCC Buddy