2027 ICD-10-CM Diagnosis Code Q06.8Other specified congenital malformations of spinal cord

ICD-10-CM Codes›Q00-Q99›Q00-Q07›Q06

ICD-10-CM Q06.8
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

Q06.8 is a billable ICD-10-CM diagnosis code for other specified congenital malformations of spinal cord. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 91 through 93, 791, 793. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Nervous system congenital anomalies.

For Medicare Advantage risk adjustment, Q06.8 maps to CMS-HCC Category 182 (Spinal Cord Disorders/Injuries) under the V28 model, adding a risk factor of about 0.478 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
Q06.8
Billable Status
Yes — Valid for Submission
Code Describes
Other specified congenital malformations of spinal cord
Short Description
Other specified congenital malformations of spinal cord
Same as the full description in the CMS dataset.
Parent Code
Other congenital malformations of spinal cord

Code Classification

ChapterQ00-Q99Congenital malformations, deformations and chromosomal abnormalities
SectionQ00-Q07Congenital malformations of the nervous system
CategoryQ06Other congenital malformations of spinal cord
This CodeQ06.8Other specified congenital malformations of spinal cord

Present on Admission (POA)Billing

Q06.8 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Congenital malformations of the nervous system (Q00-Q07).

Medicare Risk Adjustment (HCC)Billing

Q06.8 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.

CMS-HCC V28 Category (Payment Model)
HCC 182— Spinal Cord Disorders/Injuries
Payment HCC · PY 2027 one of 251 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.478
community, non-dual, aged · ranges 0.270–0.478 across segments
Hierarchy
Superseded by HCC 180, HCC 181, HCC 191, and HCC 192
a more severe related category takes the payment when both are reported
Prior Model (CMS-HCC V24)
HCC 72
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 72 · ESRD (V21): HCC 72 · ESRD (V24): HCC 72
ESRD V21 weights: 0.102 dialysis, 0.256–0.456 functioning graft · ESRD V24 weights: 0.099 dialysis, 0.222–0.523 functioning graft
Part D (RxHCC)
RxHCC 155 — Spinal Cord Disorders
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Abnormality of canalization and retrogressive differentiation
  • Caudal regression syndrome
  • Congenital dermal sinus
  • Congenital retained medullary spinal cord
  • Congenital spinal dermal sinus
  • Dysraphism of cervical spine
  • Dysraphism, cleft lip and palate, limb reduction defect syndrome
  • Enterogenous cyst
  • Hemimyelia
  • Holoprosencephaly with caudal dysgenesis syndrome
  • Limited dorsal myeloschisis
  • Lipoma due to neurospinal dysraphism
  • Lumbosacral agenesis
  • Myeloschisis
  • Neurenteric cyst
  • Neurenteric cyst of spine
  • Non-saccular limited dorsal myeloschisis
  • Occult spinal dysraphism sequence
  • Primary tethered cord syndrome
  • Saccular limited dorsal myeloschisis
  • Sacral agenesis
  • Sacral agenesis, abnormal ossification of vertebral bodies, persistent notochordal canal syndrome
  • Sacral dysgenesis
  • Structural abnormality of conus medullaris
  • Structural developmental anomalies of neurenteric canal

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to Q06.8: its own notes plus those printed at Chapter 17. A note printed at a category, block or chapter applies to every code under it.

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Chapter 17 (Q00-QA1) Congenital malformations, deformations and chromosomal abnormalities applies to 900 codes
  • inborn errors of metabolism (E70-E88)

Notes

General instructions on how these codes are used.

From Chapter 17 (Q00-QA1) Congenital malformations, deformations and chromosomal abnormalities applies to 900 codes
  • Codes from this chapter are not for use on maternal records

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Index to Diseases and InjuriesGuidance

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

Patient EducationClinical

Spinal Cord Diseases

Your spinal cord is a bundle of nerves that runs down the middle of your back. It carries signals back and forth between your body and your brain. It is protected by your vertebrae, which are the bone disks that make up your spine.

Read the full article at MedlinePlus

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

Convert Q06.8 to ICD-9-CMHistory

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

ICD-9-CM
742.59 Spinal cord anomaly NEC
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 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About Q06.8Overview

What is the ICD-10 code for other specified congenital malformations of spinal cord?

The ICD-10-CM code for other specified congenital malformations of spinal cord is Q06.8 (sometimes written as Q068). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is Q06.8 (Other congenital malformations of spinal cord) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report other specified congenital malformations of spinal cord on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does Q06.8 group to?

When other specified congenital malformations of spinal cord is the principal diagnosis on an inpatient stay, it groups to MS-DRG 793, 791, 91, 92, 93, with relative weights from 0.7783 to 4.2192 depending on complications. Higher weights mean higher Medicare reimbursement.

Is Q06.8 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 other specified congenital malformations of spinal cord on inpatient claims. The code appears in the Congenital malformations of the nervous system (Q00-Q07) range of the CMS exempt list.

What is the ICD-9 equivalent of Q06.8?

Under the General Equivalence Mappings, other specified congenital malformations of spinal cord converts to ICD-9-CM 742.59 (spinal cord anomaly NEC). The mapping is approximate, so confirm the match fits the documentation.

What HCC is Q06.8?

Q06.8 (other specified congenital malformations of spinal cord) maps to CMS-HCC Category 182 (Spinal Cord Disorders/Injuries), commonly written as HCC 182, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 72 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 155.

Does Q06.8 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, Q06.8 adds a risk adjustment factor of about 0.478 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.270 to 0.478 depending on the payment segment). A more severe related category (HCC 180, HCC 181, HCC 191, and HCC 192) supersedes it when both are reported. See the full factor table on the HCC 182 category page.