Q76.0 ICD-10-CM Code: Spina bifida occulta
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0) / Congenital malformations and deformations of the musculoskeletal system (Q65-Q79)
Q76.0
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceSpina bifida occulta
A birth defect where the spinal column fails to close completely, but there is no visible opening on the skin surface and typically no protrusion of spinal tissue.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for Q76.0 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for Q76.0 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Q76.0 in this effective period.
Excludes 1
Official- meningocele (spinal) (Q05.-)
- spina bifida (aperta) (cystica) (Q05.-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Q76.0 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Q76.0 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Q76.0 in this effective period.
Buddy Documentation Tip
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.
Is Q76.0 an HCC code?
No. Q76.0 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Q76.0 is the ICD-10-CM diagnosis code for spina bifida occulta. A birth defect where the spinal column fails to close completely, but there is no visible opening on the skin surface and typically no protrusion of spinal tissue. Q76.0 sits in the ICD-10-CM chapter for congenital malformations, deformations and chromosomal abnormalities (q00-qa0), within the section covering congenital malformations and deformations of the musculoskeletal system (q65-q79).
Q76.0 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Spina bifida occulta is often asymptomatic and may be discovered incidentally on imaging.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Q76.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Spina bifida occulta is often asymptomatic and may be discovered incidentally on imaging
- •Distinguish this from open spina bifida (Q05.x) which involves visible skin defects and tissue protrusion