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    OpenPayerBilling CodesCongenital malformations of eye, ear, face and neckICD-10-CM q13-congenital-malformations-anterior-segment
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    ICD-10-CM Code For Congenital Malformations Of Anterior Segment Of Eye: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group Q13 includes congenital malformations of the anterior segment of the eye, such as developmental anomalies of the cornea, iris, lens, and anterior chamber that may affect vision. These ICD-10-CM diagnosis codes are used to document congenital ocular anomalies and their clinical manifestations, capturing disease severity, bilateral involvement, and associated ocular complications relevant to this group. Accurate coding within the ICD-10-CM Q13 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

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    ICD-10-CM Q13: Congenital Malformations Of Anterior Segment Of Eye Overview

    The ICD-10-CM Q13 group covers congenital anomalies affecting the anterior segment of the eye, including structures such as the cornea, iris, lens, and anterior chamber. These diagnoses target developmental malformations present at birth that can impair vision and ocular function. Accurate coding matters for clear clinical documentation and supports appropriate billing and reimbursement for ophthalmologic evaluation and treatment.

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    When to Use

    Use a code from this group when documenting a congenital anterior segment ocular malformation identified on clinical exam or imaging. Select the most specific code that indicates the exact structure involved and laterality when available to reflect clinical complexity and support billing.

    ICD-10-CM Codes

    9 rows

    ICD-10-CM CodeDescription
    Q13.0Coloboma of iris
    Q13.1Absence of iris
    Q13.2Other congenital malformations of iris
    Q13.3Congenital corneal opacity
    Q13.4Other congenital corneal malformations
    Q13.5Blue sclera
    Q13.81Rieger anomaly
    Q13.89Other congenital malformations of anterior segment of eye
    Q13.9Congenital malformation of anterior segment of eye, unspecified

    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 full-term newborn is evaluated by the neonatal team after failing the red reflex screen and showing a whitish pupillary reflex; ophthalmology assessment confirms persistent pupillary membrane with adhesions affecting the iris and anterior chamber anatomy. The infant is referred for monitoring and possible early intervention to prevent amblyopia, and a congenital anterior segment malformation code is assigned to document the structural iris abnormality. Typical codes: Q13.1, Q13.4
    • A school-aged child with a history of photophobia and blurred vision presents to the pediatric ophthalmology clinic; slit-lamp exam reveals congenital aniridia with underdevelopment of the iris and associated corneal changes requiring long-term surveillance for glaucoma and keratopathy. The chronic developmental defect of the anterior segment is coded to capture the underlying congenital anomaly driving ongoing ophthalmic care. Typical codes: Q13.0, Q13.2
    • An adult patient with a known congenital anterior segment dysgenesis presents to the emergency department with acute ocular pain and sudden vision loss from secondary angle-closure glaucoma and corneal edema; treatment in the ED focuses on pressure control and emergent ophthalmologic surgery. The visit is coded to reflect the congenital malformation as the underlying cause of the acute complication requiring urgent management. Typical codes: Q13.2, Q13.89

    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

    Q11-ANOPHTHALMOS-MICROPHTHALMOS-MACROPHTHALMOS

    ICD-10-CM Code For Anophthalmos Microphthalmos And Macrophthalmos: 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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