2026 ICD-10-CM Diagnosis Code Q01.9Encephalocele, unspecified

ICD-10-CM Codes›Q00-Q99›Q00-Q07›Q01

ICD-10-CM Q01.9
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Q01.9 is a billable ICD-10-CM diagnosis code for encephalocele, unspecified. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Nervous system congenital anomalies.

Code Identity

ICD-10-CM Code
Q01.9
Billable Status
Yes — Valid for Submission
Code Describes
Encephalocele, unspecified
Short Description
Encephalocele, unspecified
Same as the full description in the CMS dataset.
Parent Code
Q01
Encephalocele

Code Classification

ChapterQ00-Q99Congenital malformations, deformations and chromosomal abnormalities
SectionQ00-Q07Congenital malformations of the nervous system
CategoryQ01Encephalocele
This CodeQ01.9Encephalocele, unspecified

Present on Admission (POA)Billing

Q01.9 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Cerebrospinal fluid otorrhea
  • Cerebrospinal fluid otorrhea due to encephalocele
  • Congenital cerebral hernia
  • Congenital cerebral meningocele
  • Congenital malformation of dural sinus
  • Encephalocele
  • Encephalocystocele
  • Encephalomyelocele
  • Isolated encephalocele
  • Meningoencephalocele
  • Sinus pericranii

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Encephalocele
    • Podencephalus
    • Sinus
      • pericranii

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR MAL004
Nervous system congenital anomalies
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Encephalocele

    brain tissue herniation through a congenital or acquired defect in the skull. the majority of congenital encephaloceles occur in the occipital or frontal regions. clinical features include a protuberant mass that may be pulsatile. the quantity and location of protruding neural tissue determines the type and degree of neurologic deficit. visual defects, psychomotor developmental delay, and persistent motor deficits frequently occur.

  • Sinus Pericranii

    rare vascular anomaly involving a communication between the intracranial and extracranial venous circulation via diploe, the central spongy layer of cranial bone. it is often characterized by dilated venous structures on the scalp due to abnormal drainage from the intracranial venous sinuses. sinus pericranii can be congenital or traumatic in origin.

  • Cerebrospinal Fluid Otorrhea

    discharge of cerebrospinal fluid through the external auditory meatus or through the eustachian tube into the nasopharynx. this is usually associated with craniocerebral trauma (e.g., skull fracture involving the temporal bone;), neurosurgical procedures; or other conditions, but may rarely occur spontaneously. (from am j otol 1995 nov;16(6):765-71)

  • Cerebrospinal Fluid Otorrhea

    discharge of cerebrospinal fluid through the ear structures.

Patient EducationClinical

Neural Tube Defects

Neural tube defects are birth defects of the brain, spine, or spinal cord. They happen in the first month of pregnancy, often before a woman even knows that she is pregnant. The two most common neural tube defects are spina bifida and anencephaly. In spina bifida, the fetal spinal column doesn't close completely.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert Q01.9 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
742.0 Encephalocele
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Q01.9Overview

Is Q01.9 (Encephalocele) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report encephalocele, unspecified on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Is Q01.9 exempt from POA reporting?

Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for encephalocele, unspecified on inpatient claims.

What is the ICD-9 equivalent of Q01.9?

Under the General Equivalence Mappings, encephalocele, unspecified converts to ICD-9-CM 742.0 (encephalocele). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.