1. ICD-10-CM Codes
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2. Q00-Q99 Congenital malformations, deformations and chromosomal abnormalities
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3. Q80-Q89 Other congenital malformations
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4. Q85- Phakomatoses, not elsewhere classified
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2020 ICD-10-CM Diagnosis Code Q85.1

Tuberous sclerosis

2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt

• Q85.1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
• The 2020 edition of ICD-10-CM Q85.1 became effective on October 1, 2019.
• This is the American ICD-10-CM version of Q85.1 - other international versions of ICD-10 Q85.1 may differ.

• Tuberous sclerosis syndrome

• A genetic disorder in which benign (not cancer) tumors form in the kidneys, brain, eyes, heart, lungs, and skin. This disease can cause seizures, mental disabilities, and different types of skin lesions.
• A triad of epilepsy, mental retardation, and angiofibromas of numerous organs with intracranial hamartomatous lesions involving subependymal nodules and cerebral cortical tubers (hence the name "tuberous sclerosis."
• Autosomal dominant disease characterized principally by the presences of hamartomas of the brain, retina, and visera; clinical manifestations include mental retardation, seizures, and adenoma sebaceum of the face.
• Autosomal dominant neurocutaneous syndrome classically characterized by mental retardation; epilepsy; and skin lesions (e.g., adenoma sebaceum and hypomelanotic macules). There is, however, considerable heterogeneity in the neurologic manifestations. It is also associated with cortical tuber and hamartomas formation throughout the body, especially the heart, kidneys, and eyes. Mutations in two loci tsc1 and tsc2 that encode hamartin and tuberin, respectively, are associated with the disease.
• Hereditary disease characterized by seizures, mental retardation, developmental delay, and skin and ocular lesions. First signs usually occur during infancy or childhood but in rare cases may not occur until 2nd or 3rd decade.
• Tuberous sclerosis is a rare genetic disease that causes noncancerous tumors to grow in the brain and other organs. Symptoms vary depending on the location of the tumors. Common symptoms include
  • skin problems, such as light patches and thickened skin
  • seizures
  • behavior problems
  • learning disabilities
  • mental retardation
  • kidney problems
  some people have signs of tuberous sclerosis at birth. In others it can take time for the symptoms to develop. In some people the disease is mild, while in others it causes severe disabilities. In rare cases, tumors in vital organs or other symptoms can be life-threatening. Tuberous sclerosis has no cure, but treatments can help symptoms. Options include medicines, educational and occupational therapy, dermabrasion, and surgery.

• Q85.1 is considered exempt from POA reporting.

• 091 Other disorders of nervous system with mcc
• 092 Other disorders of nervous system with cc
• 093 Other disorders of nervous system without cc/mcc

Convert Q85.1 to ICD-9-CM

• 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
• 2017 (effective 10/1/2016): No change
• 2018 (effective 10/1/2017): No change
• 2019 (effective 10/1/2018): No change
• 2020 (effective 10/1/2019): No change

• Bourneville's disease Q85.1
• Disease, diseased - see also Syndrome
  • Bourneville Q85.1 (-Brissaud) (tuberous sclerosis)
  • Pringle's Q85.1 (tuberous sclerosis)
• Epiloia Q85.1
• Neurospongioblastosis diffusa Q85.1
• Nevus D22.9
  ICD-10-CM Diagnosis Code D22.9

  Melanocytic nevi, unspecified

  2016 2017 2018 2019 2020 Billable/Specific Code
  • multiplex Q85.1
• Phakomatosis Q85.9
  - see also specific eponymous syndromes
  ICD-10-CM Diagnosis Code Q85.9

  Phakomatosis, unspecified

  2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt

  Applicable To

  • Hamartosis NOS
  • Bourneville's Q85.1
• Pringle's disease Q85.1 (tuberous sclerosis)
• Sclerosis, sclerotic
  • brain (generalized) (lobular) G37.9
    ICD-10-CM Diagnosis Code G37.9

    Demyelinating disease of central nervous system, unspecified

    2016 2017 2018 2019 2020 Billable/Specific Code
    • tuberous Q85.1
  • tuberous Q85.1 (brain)
• Syndrome - see also Disease
  • Bourneville Q85.1 (-Pringle)
• Tuberous sclerosis Q85.1 (brain)

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.