2025 ICD-10-CM code Q87.42
(Revised) Effective Date: N/A Revision Date: N/A Congenital malformations - Other specified congenital malformation syndromes affecting multiple systems Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99) Feed
Marfan syndrome with ocular manifestations.
Modifiers are generally not applicable to ICD-10-CM codes.
The medical necessity for coding Q87.42 is established through thorough clinical documentation supporting the diagnosis of Marfan syndrome with associated ocular manifestations. This includes documentation of the appropriate clinical findings, family history, and investigations to confirm the diagnosis.The coding must be supported by clear and precise documentation that fulfills payer requirements and justifies the medical necessity of treatment and procedures.
The clinical responsibility for coding Q87.42 rests with the physician or qualified healthcare professional who diagnoses and manages the patient's Marfan syndrome, including its ocular manifestations. This involves a thorough clinical evaluation, possibly including genetic testing, ophthalmological examination, and assessment of cardiovascular and skeletal involvement. The physician should document all findings to support the coding choice.
- Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- Q87 (Other specified congenital malformation syndromes affecting multiple systems)
In simple words: This code describes Marfan syndrome, a genetic condition causing problems with the body's connective tissues.In this case, the eyes are also affected.
This code is used to classify Marfan syndrome cases where ocular manifestations are present.Marfan syndrome is a genetic disorder affecting connective tissue, leading to a range of symptoms involving the cardiovascular, skeletal, and ocular systems. Ocular manifestations can include ectopia lentis (lens dislocation), myopia (nearsightedness), and retinal detachment.
Example 1: A 25-year-old female patient presents with a family history of Marfan syndrome.She exhibits ectopia lentis (lens dislocation) in both eyes and is diagnosed with Marfan syndrome with ocular manifestations (Q87.42).Further cardiac and skeletal evaluations are necessary., A 10-year-old male patient presents with tall stature, arachnodactyly (long fingers), and myopia (nearsightedness).Ophthalmological examination confirms ectopia lentis.He is diagnosed with Marfan syndrome with ocular manifestations (Q87.42), and additional testing and specialist referrals are scheduled., A 40-year-old male patient is diagnosed with Marfan syndrome. He presents with significant aortic dilation (Q87.410) and, during a routine eye examination, shows evidence of retinal detachment, a common ocular manifestation associated with Marfan Syndrome.Both conditions are coded: Q87.410 and Q87.42.
Detailed documentation should include a comprehensive history and physical examination emphasizing the patient's family history, physical findings consistent with Marfan syndrome (e.g., tall stature, arachnodactyly, pectus excavatum), and a detailed ophthalmological examination documenting specific ocular findings such as ectopia lentis, myopia, retinal detachment, or other abnormalities.Genetic testing results, echocardiography, and skeletal surveys should also be documented when relevant.
** This code should only be used when Marfan syndrome is definitively diagnosed and ocular manifestations are present. If there is uncertainty about the diagnosis, consultation with a specialist is advised.Remember that this is just one piece of information needed for accurate reimbursement; complete and detailed documentation is crucial.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Specialties:Cardiology, Genetics, Ophthalmology
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient