Q85.02 ICD-10-CM Code: Neurofibromatosis, type 2
Q85.02 maps to CMS-HCC V28 23. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Congenital malformations, deformations and chromosomal abnormalities (Q00-QA0) / Other congenital malformations (Q80-Q89)
Q85.02
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceNeurofibromatosis, type 2
Neurofibromatosis type 2 is an inherited genetic disorder characterized by benign tumors on the hearing nerves and other nerve tissues, often causing hearing loss.
Buddy Insight
Neurofibromatosis type 2 is a rare but serious genetic disorder characterized by bilateral acoustic neuromas with high risk of hearing loss and other central nervous system tumors, requiring specialized neurosurgical and audiological management.
CMS-HCC V28
MappedHCC 23
Code-level coefficient reference
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 013
Code-level coefficient reference
ESRD/PACE
MappedHCC 12
Code-level coefficient reference
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Acoustic neurofibromatosis
Excludes 2
Official- inborn errors of metabolism (E70-E88)Inherited from Q00-QA0
Related Codes
Includes
OfficialNo Includes notes are included in this display for Q85.02. Check the code and parent instructions in the Code Book.
Excludes 1
Official- ataxia telangiectasia [Louis-Bar] (G11.3)Inherited from Q85
- familial dysautonomia [Riley-Day] (G90.1)Inherited from Q85
Code First
OfficialNo Code First sequencing instructions are included in this display for Q85.02. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for Q85.02. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for Q85.02. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 →
Is Q85.02 an HCC code?
Yes. Q85.02 (Neurofibromatosis, type 2) maps to HCC 23, Prostate, Breast, and Other Cancers and Tumors under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.186. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: Q85.02 is billable and maps to V28 HCC 23, Prostate, Breast, and Other Cancers and Tumors. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- Q85.02
- Description
- Neurofibromatosis, type 2
- HCC (V28)
- HCC 23 — Prostate, Breast, and Other Cancers and Tumors
- RAF reference coefficient
- 0.186
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work Q85.02 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for Q85.02
For Q85.02, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Coder workflow notes
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What This Code Means
Q85.02 is the ICD-10-CM diagnosis code for neurofibromatosis, type 2. Neurofibromatosis type 2 is an inherited genetic disorder characterized by benign tumors on the hearing nerves and other nerve tissues, often causing hearing loss. Q85.02 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).
Under the CMS-HCC V28 risk adjustment model, Q85.02 maps to Prostate, Breast, and Other Cancers and Tumors (HCC 23) with a source-labeled community, non-dual, aged reference coefficient of 0.186. No V24 mapping is shown for Q85.02; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
NF2 typically presents with bilateral acoustic neuromas; document hearing loss and other neurological manifestations. For Q85.02, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for Q85.02 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •NF2 typically presents with bilateral acoustic neuromas; document hearing loss and other neurological manifestations
- •Link this code with codes for associated conditions like hearing impairment or neurological complications
Clinical Significance
Neurofibromatosis type 2 is a rare but serious genetic disorder characterized by bilateral acoustic neuromas with high risk of hearing loss and other central nervous system tumors, requiring specialized neurosurgical and audiological management. The condition often presents in young adults and can be life-altering, making early diagnosis and intervention crucial for preserving function.
Documentation Requirements
- ✓Bilateral vestibular schwannomas (acoustic neuromas)
- ✓Unilateral vestibular schwannoma plus family history of NF2
- ✓Multiple meningiomas plus unilateral vestibular schwannoma
- ✓Genetic testing confirming NF2 gene mutation
- ✓Audiological assessment documentation
- ✓MRI findings of central nervous system tumors
- ✓Family history and genetic counseling records