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Q85 ICD-10-CM Code: Phakomatoses, not elsewhere classified

Q85 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

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Code lookupQ85

FY 2026 Apr update / Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0) / Other congenital malformations (Q80-Q89)

Q85

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

Phakomatoses, not elsewhere classified

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

Inclusion Terms

Official

No inclusion terms are included in this display for Q85. Check the code and parent instructions in the Code Book.

Excludes 2

Official
  • inborn errors of metabolism (E70-E88)Inherited from Q00-QA0

Includes

Official

No Includes notes are included in this display for Q85. Check the code and parent instructions in the Code Book.

Excludes 1

Official
  • ataxia telangiectasia [Louis-Bar] (G11.3)
  • familial dysautonomia [Riley-Day] (G90.1)

Code First

Official

No Code First sequencing instructions are included in this display for Q85. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for Q85. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for Q85. 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
Q85
Description
Phakomatoses, not elsewhere classified
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

Q85 is the ICD-10-CM diagnosis code for phakomatoses, not elsewhere classified. Q85 sits in the ICD-10-CM chapter for congenital malformations, deformations and chromosomal abnormalities (q00-qa0), within the section covering other congenital malformations (q80-q89).

Header codes like Q85 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 Q85 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • ataxia telangiectasia [Louis-Bar] (G11.3)
  • familial dysautonomia [Riley-Day] (G90.1)

Child Codes

Code Hierarchy

Q85Phakomatoses, not elsewhere classified
Q85Phakomatoses, not elsewhere classified

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