Neurosurgery Coding Alert

Question: There are a lot of very specific-sounding conditions under the Q75.-base code in ICD-10. Can you give me any information on how to make the 4th character decision for these codes?

Massachusetts Subscriber

Answer: From humble beginnings, Q75.- (Other congenital malformations of skull and face bones) explodes into an array of 4th character choices, which often leave coders flummoxed on how best to proceed.

Check this out: Here’s a brief rundown on how to identify each of the 4th character options for Q75:

• Q75.0 (Craniosynostosis) “is a birth defect in which the bones in a baby’s skull join together too early,” according to the Centers for Disease Control and Prevention (CDC).
• Q75.1 (Craniofacial dysostosis) also known as Crouzon syndrome or craniofacial dysostosis, “is primarily charac­terized by premature closure of the fibrous joints (cranial sutures) between certain bones in the skull (craniosyn­ostosis) and distinctive facial abnormalities,” according to rarediseases.org.
• Q75.2 (Hypertelorism) is defined as an increased distance between the orbits (eye sockets).
• Q75.3 (Macrocephaly) refers to “children with … a head circumference (the measurement around the widest part of the head) that is greater than the 98th percentile,” according to Children’s Hospital at Dartmouth-Hitchcock.
• Q75.4 (Mandibulofacial dysostosis) also known as Treacher Collins syndrome, “is a rare syndrome characterized by underdeveloped facial bones and a very small lower jaw and chin,” according to University of California San Francisco Benioff Children’s Hospitals.
• Q75.5 (Oculomandibular dysostosis) is a defect in ossification of bone. Symptoms include abnormalities of the head and facial region; and underdeveloped midface or cheekbones.

If none of those codes fits your Q75.- patient, choose from Q75.8 (Other specified congenital malformations of skull and face bones) and Q75.9 (Congenital malformation of skull and face bones, unspecified).