2027 ICD-10-CM Diagnosis Code Q12.4Spherophakia

ICD-10-CM Codes›Q00-Q99›Q10-Q18›Q12

ICD-10-CM Q12.4
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

Q12.4 is a billable ICD-10-CM diagnosis code for spherophakia. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) 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 the other POA exempt codes in Congenital malformations of eye, ear, face and neck (Q10-Q18).

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

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to Q12.4: its own notes plus those printed at block Q10-Q18 and 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 Block Q10-Q18 Congenital malformations of eye, ear, face and neck applies to 62 codes
  • cleft lip and cleft palate (Q35-Q37)
  • congenital malformation of cervical spine (Q05.0, Q05.5, Q67.5, Q76.0-Q76.4)
  • congenital malformation of larynx (Q31.-)
  • congenital malformation of lip NEC (Q38.0)
  • congenital malformation of nose (Q30.-)
  • congenital malformation of parathyroid gland (Q89.2)
  • congenital malformation of thyroid gland (Q89.2)
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.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name Q12.4, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming Q12.4: they are not reported together with it, unless the two conditions are unrelated.

  • H27 Other disorders of lens
    congenital lens malformations (Q12.-) names Q12.-, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

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.

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 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About Q12.4Overview

What is the ICD-10 code for spherophakia?

The ICD-10-CM code for spherophakia is Q12.4 (sometimes written as Q124). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

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, 2026 through September 30, 2027.

What MS-DRG does Q12.4 group to?

When spherophakia is the principal diagnosis on an inpatient stay, it groups to MS-DRG 125, 124, with relative weights from 0.7699 to 1.2470 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. The code appears in the Congenital malformations of eye, ear, face and neck (Q10-Q18) range of the CMS exempt list.

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.