2025 ICD-10-CM code Q85.00
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Congenital malformations - Other congenital malformations (Q80-Q89) Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99) Feed
Neurofibromatosis, unspecified; a genetic disorder causing tumors to grow along nerves.
Medical necessity for coding Q85.00 is established by the presence of clinical findings suggestive of neurofibromatosis (café-au-lait spots, neurofibromas, etc.), which are further confirmed through genetic testing, imaging, or other relevant investigations. The medical necessity for specific treatments would be separately justified based on clinical indications.
The clinical responsibility for managing a patient with Q85.00 involves a multidisciplinary approach that might include neurologists, geneticists, surgeons, and oncologists.Responsibilities include diagnosis through clinical examination, genetic testing, and imaging studies (MRI, CT scan); treatment planning, surgical interventions if needed, and management of any complications; counseling and long-term monitoring for tumor progression and associated complications.
In simple words: This code describes neurofibromatosis, a condition where tumors grow on nerves.These tumors can be small or large and can affect different parts of the body.Some people with this condition may have few symptoms while others may have more serious problems.Doctors use imaging and genetic testing to diagnose and treat this condition.
Q85.00, Neurofibromatosis, unspecified, is an ICD-10-CM code classifying a genetic disorder characterized by the development of tumors along nerves.These tumors can vary in size and location, impacting various body systems. The severity and specific manifestations can differ significantly between individuals.Diagnosis often involves clinical evaluation, genetic testing, and imaging studies to assess the extent and location of tumors. Treatment approaches are individualized and may include observation, surgery, medication, or radiation therapy, depending on the severity and location of the tumors.
Example 1: A 5-year-old child presents with café-au-lait spots and multiple neurofibromas.Genetic testing confirms a diagnosis of Neurofibromatosis type 1.Q85.00 is coded to reflect the unspecified type., A 30-year-old adult presents with hearing loss and a large neurofibroma near the auditory nerve. Imaging confirms the presence of the tumor. Q85.00 is used, and further diagnostic testing to determine the neurofibromatosis type may be necessary., A 45-year-old patient is monitored for neurofibromatosis type 1, and during a routine checkup, new skin lesions are found.The code Q85.00 is used pending further investigation.
Detailed medical history including family history of neurofibromatosis, physical examination findings (café-au-lait spots, neurofibromas, Lisch nodules), imaging studies (MRI, CT scan) to assess the size and location of tumors, genetic testing results to confirm the diagnosis (if performed), results of any other diagnostic studies as clinically relevant.Detailed descriptions of any symptoms or complications.Treatment plan details if applicable.
** Excludes1: ataxia telangiectasia (Louis-Bar syndrome), familial dysautonomia (Riley-Day syndrome).This code is not for use on maternal records.Appropriate documentation is crucial for accurate coding and reimbursement.
- Payment Status: Active
- Specialties:Genetics, Neurology, Neurosurgery, Oncology
- Place of Service:Office, Hospital (Inpatient and Outpatient), Clinic