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    v1.0.28
    OpenPayerBilling CodesCongenital malformations of the nervous systemICD-10-CM q05-spina-bifida
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    ICD-10-CM Code For Spina Bifida: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group Q05 includes congenital malformations of the spinal cord and vertebral arches such as spina bifida occulta, spina bifida with meningocele, myelomeningocele, and other specified or unspecified forms that can involve neural and musculoskeletal structures. These ICD-10-CM diagnosis codes are used to document clinical presentations ranging from asymptomatic vertebral defects to complex myelomeningocele with neurologic deficits, hydrocephalus, or other associated anomalies, capturing disease severity and organ involvement. Accurate coding within the ICD-10-CM Q05 group supports complete clinical documentation and appropriate reimbursement.

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    ICD-10-CM Q05: Spina Bifida Overview

    The ICD-10-CM Q05 group captures congenital malformations of the spinal cord and vertebral arches collectively known as spina bifida. These diagnoses affect the nervous system and frequently involve the spinal cord, meninges, nerve roots, and overlying structures, with variable neurologic and orthopedic sequelae. Accurate coding matters for complete clinical documentation and supports appropriate reimbursement by reflecting disease complexity and associated care needs.

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    When to Use

    Use a code from this group when documenting a congenital defect of the vertebral arches or spinal cord present from birth that is clinically identified as spina bifida or a related neural tube defect. Select the most specific code that reflects the type of defect (occulta, meningocele, myelomeningocele, or other) and any documented associated conditions such as hydrocephalus or neurological impairment.

    ICD-10-CM Codes

    10 rows

    ICD-10-CM CodeDescription
    Q05.0Cervical spina bifida with hydrocephalus
    Q05.1Thoracic spina bifida with hydrocephalus
    Q05.2Lumbar spina bifida with hydrocephalus
    Q05.3Sacral spina bifida with hydrocephalus
    Q05.4Unspecified spina bifida with hydrocephalus
    Q05.5Cervical spina bifida without hydrocephalus
    Q05.6Thoracic spina bifida without hydrocephalus
    Q05.7Lumbar spina bifida without hydrocephalus
    Q05.8Sacral spina bifida without hydrocephalus
    Q05.9Spina bifida, unspecified

    DRG Codes

    5 rows

    DRG CodeDescription
    091Other Disorders of Nervous System with MCC
    092Other Disorders of Nervous System with CC
    093Other Disorders of Nervous System without CC/MCC
    791Prematurity with Major Problems
    793Full Term Neonate with Major Problems

    Typical Clinical Scenarios

    • An infant is born after an uncomplicated pregnancy but on newborn exam has a midline lumbosacral tuft of hair and a palpable sac at the lower spine; ultrasound and MRI confirm a meningocele without neurologic deficit. The newborn is referred to pediatric neurosurgery for evaluation and repair of the neural tube defect, and the diagnosis is recorded to document the congenital malformation and guide perioperative planning. Typical codes: Q05.1, Q05.2
    • A school-age child with a known history of repaired spina bifida presents to clinic for ongoing multidisciplinary care for lower extremity weakness, neurogenic bladder, and orthopedic deformities; current imaging shows spina bifida occulta without an open spinal defect. The visit documents chronic neurologic sequelae of the congenital malformation and is coded to reflect the type of defect underlying the child’s long-term impairments and need for continued surveillance. Typical codes: Q05.8, Q05.9
    • An adult with a history of myelomeningocele repaired in childhood presents to the emergency department with new sacral pressure ulcer and worsening bowel and bladder incontinence; examination and imaging reveal tethered cord causing progressive neurologic decline related to the congenital lesion. The encounter focuses on a complication of the underlying congenital spinal malformation that requires acute management and potential surgical referral, so a code indicating the specific form of spina bifida and related complication is assigned. Typical codes: Q05.0, Q05.6}

    Related Codes

    Q00-ANENCEPHALY-AND-SIMILAR-MALFORMATIONS

    ICD-10-CM Code For Anencephaly And Similar Malformations: Group Overview

    Q01-ENCEPHALOCELE

    ICD-10-CM Code For Encephalocele: Group Overview

    Q02-MICROCEPHALY

    ICD-10-CM Code For Microcephaly: Group Overview

    Q03-CONGENITAL-HYDROCEPHALUS

    ICD-10-CM Code For Congenital Hydrocephalus: Group Overview

    Q04-OTHER-CONGENITAL-MALFORMATIONS-OF-BRAIN

    ICD-10-CM Code For Other Congenital Malformations Of Brain: Group Overview

    Q06-OTHER-CONGENITAL-MALFORMATIONS-OF-SPINAL-CORD

    ICD-10-CM Code For Other Congenital Malformations Of Spinal Cord: Group Overview

    Q07-OTHER-CONGENITAL-MALFORMATIONS-NERVOUS-SYSTEM

    ICD-10-CM Code For Other Congenital Malformations Of Nervous System: Group Overview

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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