2026 ICD-10-CM Diagnosis Code Q11.1Other anophthalmos

ICD-10-CM Codes›Q00-Q99›Q10-Q18›Q11

ICD-10-CM Q11.1
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Q11.1 is a billable ICD-10-CM diagnosis code for other anophthalmos. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 124 through 125. The code is exempt from POA reporting. Coders also document this condition as anophthalmia and megalocornea with cardiopathy and skeletal anomalies syndrome. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Congenital malformations of eye, ear, face, neck.

Code Identity

ICD-10-CM Code
Q11.1
Billable Status
Yes — Valid for Submission
Code Describes
Other anophthalmos
Short Description
Other anophthalmos
Same as the full description in the CMS dataset.
Parent Code
Q11
Anophthalmos, microphthalmos and macrophthalmos

Code Classification

ChapterQ00-Q99Congenital malformations, deformations and chromosomal abnormalities
SectionQ10-Q18Congenital malformations of eye, ear, face and neck
CategoryQ11Anophthalmos, microphthalmos and macrophthalmos
This CodeQ11.1Other anophthalmos

Present on Admission (POA)Billing

Q11.1 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.

  • Anophthalmia and megalocornea with cardiopathy and skeletal anomalies syndrome
  • Anophthalmia plus syndrome
  • Anophthalmos
  • Anophthalmos of left eye
  • Anophthalmos of right eye
  • Bilateral anophthalmos of eyes
  • Congenital anophthalmos with orbital implant
  • Monophthalmos
  • SOX2 anophthalmia syndrome

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

  • Anophthalmos NOS
  • Agenesis of eye
  • Aplasia of eye

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.

    • Absence(of) (organ or part) (complete or partial)
      • eye (acquired)
        • congenital
    • Absence(of) (organ or part) (complete or partial)
      • globe (acquired)
        • congenital
    • Agenesis
      • eye
    • Anophthalmos, anophthalmus(congenital) (globe)
    • Aplasia
      • eye

Clinical ClassificationClinical

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

CCSR MAL005
Congenital malformations of eye, ear, face, neck
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Anophthalmos

    congenital absence of the eye or eyes.

  • Anophthalmos

    a rare congenital abnormality characterized by the complete absence of ocular tissue in the orbit.

  • Bilateral Anophthalmos|Anophthalmos, Bilateral

    a rare congenital abnormality characterized by the complete absence of ocular tissue in both orbits.

  • Unilateral Anophthalmos|Anophthalmos, Unilateral

    a rare congenital abnormality characterized by the complete absence of ocular tissue in one orbit.

  • Nanophthalmos 2|Autosomal Recessive Nanophthalmos|NNO2

    an autosomal recessive form of nanophthalmos caused by mutation(s) in the mfrp gene, encoding membrane frizzled-related protein.

Patient EducationClinical

Birth Defects

A birth defect is a problem that happens while a baby is developing in the mother's body. Most birth defects happen during the first 3 months of pregnancy. One out of every 33 babies in the United States is born with a birth defect.

The full article covers:

  • What are birth defects?
  • What causes birth defects?
  • Who is at risk of having a baby with birth defects?
  • How are birth defects diagnosed?
  • What are the treatments for birth defects?
  • Can birth defects be prevented?

Read the full article at MedlinePlus

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

Convert Q11.1 to ICD-9-CMHistory

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

ICD-9-CM
743.00 Clinic anophthalmos NOS
Exact Match The mapping is direct, with no qualifiers.

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 Q11.1Overview

Is Q11.1 (Anophthalmos, microphthalmos and macrophthalmos) a billable code?

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

What MS-DRG does Q11.1 group to?

When other anophthalmos is the principal diagnosis on an inpatient stay, it groups to MS-DRG 124, 125, with relative weights from 0.7678 to 1.3231 depending on complications. Higher weights mean higher Medicare reimbursement.

Is Q11.1 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 anophthalmos on inpatient claims.

What is the ICD-9 equivalent of Q11.1?

Under the General Equivalence Mappings, other anophthalmos converts to ICD-9-CM 743.00 (clinic anophthalmos NOS). The mapping is a direct match.

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.