2026 ICD-10-CM Diagnosis Code Q12.4Spherophakia

ICD-10-CM Codes›Q00-Q99›Q10-Q18›Q12

ICD-10-CM Q12.4
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Q12.4 is a billable ICD-10-CM diagnosis code for spherophakia. 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. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Congenital malformations of eye, ear, face, neck.

Code Identity

ICD-10-CM Code
Q12.4
Billable Status
Yes — Valid for Submission
Code Describes
Spherophakia
Short Description
Spherophakia
Same as the full description in the CMS dataset.
Parent Code
Q12
Congenital lens malformations

Code Classification

ChapterQ00-Q99Congenital malformations, deformations and chromosomal abnormalities
SectionQ10-Q18Congenital malformations of eye, ear, face and neck
CategoryQ12Congenital lens malformations
This CodeQ12.4Spherophakia

Present on Admission (POA)Billing

Q12.4 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.

  • Bilateral spherophakia
  • GEMSS syndrome
  • Ichthyosis, short stature, brachydactyly, microspherophakia syndrome
  • Isolated microspherophakia
  • Lentiglobus
  • Megalocornea
  • Megalocornea, spherophakia, secondary glaucoma syndrome
  • Microphakia
  • Microspherophakia
  • Microspherophakia with metaphyseal dysplasia syndrome
  • Spherophakia

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.

    • Increase, increased
      • sphericity, lens
    • Sphericity, increased, lens(congenital)
    • Spherophakia

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

  • Spherophakia

    a congenital disorder of the eye where the lens is abnormally small and spherical.

  • Weill-Marchesani Syndrome 1|Congenital Mesodermal Dysmorphodystrophy|Spherophakia-Brachymorphia Syndrome|Spherophakia-brachymorphia syndrome|Weill-Marchesani, Autosomal Recessive

    an autosomal recessive subtype of weill-marchesani syndrome caused by mutations in the adamts10 gene, encoding a disintegrin and metalloproteinase with thrombospondin motifs 10.

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 Q12.4 to ICD-9-CMHistory

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

ICD-9-CM
743.36 Anomalies of lens shape
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 Q12.4Overview

Is Q12.4 (Congenital lens malformations) a billable code?

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

What MS-DRG does Q12.4 group to?

When spherophakia 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 Q12.4 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 spherophakia on inpatient claims.

What is the ICD-9 equivalent of Q12.4?

Under the General Equivalence Mappings, spherophakia converts to ICD-9-CM 743.36 (anomalies of lens shape). 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.