October 1 update. Our PDGM and ICD-10 tools now use the FY2027 code set: 190 codes added, 30 deleted, and no existing code changed clinical group.

See what changed

ICD-10 · PDGM grouping

Q01 Encephalocele

All 5 codes in the Q01 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.

ICD-10-CM FY2027 · CMS grouper v07.2.26

Codes in family

5

Can lead a claim

0

Cannot lead a claim

5

What CMS assigns to Q01

None of the 5 codes is assigned a clinical group. None of the 5 is assigned a comorbidity subgroup. None can lead a claim.

Every code in Q01

Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.

CodeDescriptionPrimary positionClinical groupComorbidity subgroup
Q01.0Frontal encephaloceleCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Q01.1Nasofrontal encephaloceleCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Q01.2Occipital encephaloceleCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Q01.8Encephalocele of other sitesCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone
Q01.9Encephalocele, unspecifiedCannot lead a claimPrincipal diagnosis not assigned to a clinical groupNoneNone

Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.

The monthly home health regs digest

What CMS changed, what's due next, and what to do about it — one email a month, no fluff. Read the first issue