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    OpenPayerBilling CodesCongenital malformations of eye, ear, face and neckICD-10-CM q11-anophthalmos-microphthalmos-macrophthalmos
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    ICD-10-CM Code For Anophthalmos Microphthalmos And Macrophthalmos: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group Q11 includes congenital malformations of eye size such as anophthalmos (absent eye), microphthalmos (abnormally small eye), and macrophthalmos (abnormally large eye), covering unilateral and bilateral presentations. These ICD-10-CM diagnosis codes are used to document congenital ocular size abnormalities, capturing laterality and severity where specified to reflect clinical complexity. Accurate coding within the ICD-10-CM Q11 group supports proper claim adjudication and complete clinical documentation for congenital eye conditions.

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    ICD-10-CM Q11: Anophthalmos, Microphthalmos And Macrophthalmos Overview

    The ICD-10-CM Q11 group covers congenital abnormalities of eye size and development, including absent eye(s), abnormally small eye(s), and abnormally large eye(s). These conditions affect the ocular system and are identified at birth or in early childhood. Accurate coding matters for appropriate clinical documentation and can impact reimbursement and resource allocation for congenital ocular care.

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    When to Use

    Use a code from this group when a congenital ocular size malformation such as anophthalmos, microphthalmos, or macrophthalmos is diagnosed and documented. Select codes that reflect laterality and any specified severity to accurately represent the clinical scenario.

    ICD-10-CM Codes

    4 rows

    ICD-10-CM CodeDescription
    Q11.0Cystic eyeball
    Q11.1Other anophthalmos
    Q11.2Microphthalmos
    Q11.3Macrophthalmos

    DRG Codes

    2 rows

    DRG CodeDescription
    124Other Disorders of the Eye with MCC or Thrombolytic Agent
    125Other Disorders of the Eye without MCC

    Typical Clinical Scenarios

    • A newborn is noted on initial neonatal exam to have a visibly absent globe on one side with a shallow or absent orbit; parents report no prenatal history of infections or teratogen exposure. The infant is referred to pediatric ophthalmology and genetics for evaluation of a congenital absence of the eyeball and associated facial asymmetry, and a congenital anophthalmia code is assigned. Typical codes: Q11.0
    • A pediatric patient presents to a clinic for ongoing management of an abnormally small, underdeveloped eye identified since birth; visual acuity is limited and there are associated microcornea and strabismus findings. The visit documents the congenital small globe (microphthalmos) as the primary ocular diagnosis guiding surgical planning and low-vision services, so a microphthalmos code is used. Typical codes: Q11.1, Q11.2
    • An adult with a history of congenital ocular malformation is evaluated for prosthetic eye fitting after prior enucleation for a severely enlarged congenital globe causing pain and exposure keratopathy in childhood. The current encounter documents sequelae of a congenital macrophthalmia and plans for orbital prosthesis and socket reconstruction, warranting assignment of the appropriate congenital enlargement code. Typical codes: Q11.3

    Related Codes

    Q10-CONGENITAL-MALFORMATIONS-OF-EYELID-LACRIMAL-APPARATUS-AND-ORBIT

    ICD-10-CM Code For Congenital Malformations Of Eyelid Lacrimal Apparatus And Orbit: Group Overview

    Q13-CONGENITAL-MALFORMATIONS-ANTERIOR-SEGMENT

    ICD-10-CM Code For Congenital Malformations Of Anterior Segment Of Eye: Group Overview

    Q14-CONGENITAL-MALFORMATIONS-POSTERIOR-EYE

    ICD-10-CM Code For Congenital Malformations Of Posterior Segment Of Eye: Group Overview

    Q15-OTHER-CONGENITAL-MALFORMATIONS-OF-EYE

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

    Q16-CONGENITAL-MALFORMATIONS-OF-EAR

    ICD-10-CM Code For Congenital Malformations Of Ear Causing Impairment Of Hearing: Group Overview

    Q17-OTHER-CONGENITAL-MALFORMATIONS-OF-EAR

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

    Q18-OTHER-CONGENITAL-MALFORMATIONS-FACE-NECK

    ICD-10-CM Code For Other Congenital Malformations Of Face And Neck: 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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