2025 ICD-10-CM code Q67.5
Congenital deformity of spine. This includes congenital postural scoliosis and congenital scoliosis NOS.
Medical necessity for interventions related to Q67.5 must be clearly established. Documentation should justify the need for diagnostic testing, bracing, surgical correction, physical therapy, or pain management based on the specific impact of the congenital spinal deformity on the patient's health and function. This justification might include evidence of progressive curvature, neurological compromise, pain that interferes with daily activities, or respiratory compromise in severe cases. Payer-specific guidelines for medical necessity should also be consulted.
Diagnosis and management of congenital spinal deformities typically falls under the purview of specialists like orthopedists, neurosurgeons, and pediatricians specializing in developmental disorders. These professionals are responsible for accurate diagnosis, assessment of severity, treatment planning (which may include bracing, surgery, or other interventions), and ongoing monitoring of the condition.
In simple words: This code represents a deformity of the spine that is present from birth. It includes conditions like congenital scoliosis, which is a sideways curvature of the spine.
Congenital deformity of spine. This includes congenital postural scoliosis and congenital scoliosis NOS.Excludes1: infantile idiopathic scoliosis (M41.0) and scoliosis due to congenital bony malformation (Q76.3).Excludes2: inborn errors of metabolism (E70-E88). Codes from this chapter are not for use on maternal records.
Example 1: A newborn infant is diagnosed with a noticeable curvature of the spine during a routine physical examination. Imaging studies reveal a congenital malformation of the vertebrae, and the diagnosis of congenital scoliosis is made using code Q67.5., A toddler presents with an asymmetric posture and uneven shoulder heights. Diagnostic imaging shows congenital wedging of the vertebrae, leading to a diagnosis of congenital kyphoscoliosis, also coded as Q67.5., A child experiences progressive back pain and stiffness. Thorough evaluation and imaging studies identify a previously undiagnosed congenital spinal deformity causing restricted movement and discomfort. Q67.5 is used to document the underlying congenital spinal deformity.
Thorough documentation is crucial for accurate coding.This includes detailed clinical findings from physical examinations, imaging reports (X-rays, CT scans, MRI scans) confirming the congenital nature and specifics of the spinal deformity, and any associated neurological deficits. In cases with progressive symptoms, serial imaging studies and documentation of functional limitations are essential.If surgical intervention is undertaken, operative reports and post-operative progress notes must be included.
- Specialties:Orthopedic Surgery, Neurosurgery, Pediatric Genetics, Pediatrics
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital, Office