Q85.83
BillableVon Hippel-Lindau syndrome
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Q85.83 an HCC code?
Yes. Q85.83 maps to Melanoma and Other Skin Cancers under the CMS-HCC V28 risk adjustment model (and Breast, Prostate, and Other Cancers and Tumors under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for Q85.83
For Q85.83 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- 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
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed Q85.83 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
Q85.83 is the ICD-10-CM diagnosis code for von hippel-lindau syndrome. Von Hippel-Lindau syndrome is an inherited genetic disorder that causes tumors and cysts to develop in multiple organs, particularly the brain, spinal cord, kidneys, and pancreas. Q85.83 sits in the ICD-10-CM chapter for congenital malformations, deformations, chromosomal abnormalities, and genetic disorders (q00-qa0), within the section covering other congenital malformations (q80-q89).
Under the CMS-HCC V28 risk adjustment model, Q85.83 maps to Melanoma and Other Skin Cancers (HCC 23) with a community, non-dual, aged base RAF weight of 0.251. Under the older CMS-HCC V24 model, Q85.83 maps to Breast, Prostate, and Other Cancers and Tumors (HCC 12) with a community, non-dual, aged base RAF weight of 0.150. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
This is a specific phakomatosis code; do not use the unspecified code Q85.9 when VHL syndrome is documented. Because Q85.83 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. 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, RAF weights, and MEAT documentation criteria for Q85.83 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a specific phakomatosis code; do not use the unspecified code Q85.9 when VHL syndrome is documented
- •Document any associated manifestations (hemangioblastomas, renal cell carcinoma, pheochromocytoma) with additional codes for complete clinical picture
Clinical Significance
Von Hippel-Lindau syndrome is a rare genetic tumor predisposition syndrome with high risk of developing multiple types of tumors and cysts throughout life, including potentially life-threatening complications like renal cell carcinoma and pheochromocytomas. The condition requires intensive lifelong surveillance and often multiple surgical interventions, significantly impacting quality of life and requiring specialized management.
Documentation Requirements
- ✓VHL gene mutation confirmation or clinical criteria
- ✓CNS hemangioblastomas documented
- ✓Retinal angiomas and ophthalmologic surveillance
- ✓Renal manifestations (clear cell carcinoma, cysts)
- ✓Pheochromocytomas or paragangliomas
- ✓Pancreatic involvement (cysts, neuroendocrine tumors)
- ✓Family history and genetic counseling
- ✓Comprehensive surveillance protocol implementation
Code Also
- manifestations