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v1.0.0
ICD-10 Guide
ICD-10 CodesQ85.82

Q85.82

Billable

Other Cowden syndrome

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 Q85.82 is a billable code used to indicate a diagnosis of other cowden syndrome.

Key Diagnostic Point:

Other Cowden syndrome is a rare genetic disorder characterized by multiple hamartomas and an increased risk of certain cancers, particularly breast and thyroid cancers. It is part of the PTEN hamartoma tumor syndrome, which is caused by mutations in the PTEN gene. Clinically, patients may present with skin lesions such as trichilemmomas, acral keratoses, and fibromas, as well as breast abnormalities including fibrocystic changes and adenomas. Other congenital malformations associated with this syndrome can include abnormalities of the spleen, adrenal glands, and other rare malformations. The condition often manifests in childhood or early adulthood, and early diagnosis is crucial for management and surveillance of associated malignancies. Genetic counseling is recommended for affected individuals and their families due to the hereditary nature of the disorder.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and associated conditions
  • Need for genetic testing results to confirm diagnosis
  • Potential overlap with other genetic syndromes
  • Documentation of multiple congenital anomalies

Audit Risk Factors

  • Inadequate documentation of associated congenital anomalies
  • Failure to include genetic testing results
  • Misclassification of related syndromes
  • Lack of follow-up documentation for malignancy surveillance

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed family history, growth and development assessments, and descriptions of skin lesions.

Common Clinical Scenarios

Pediatric patients presenting with skin lesions, family history of Cowden syndrome, or unexplained growth abnormalities.

Billing Considerations

Attention to the developmental milestones and psychosocial impact of congenital anomalies.

Genetics

Documentation Requirements

Genetic testing results, family pedigree, and detailed descriptions of phenotypic manifestations.

Common Clinical Scenarios

Patients undergoing genetic counseling for familial risk assessment or presenting with multiple hamartomas.

Billing Considerations

Understanding the implications of PTEN mutations and the need for cancer surveillance.

Coding Guidelines

Inclusion Criteria

Use Q85.82 When
  • Follow the official ICD
  • CM guidelines for coding congenital conditions, ensuring accurate documentation of all associated anomalies and genetic testing results

Exclusion Criteria

Do NOT use Q85.82 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

81214CPT Code

PTEN gene analysis

Clinical Scenario

Used for confirming diagnosis in patients suspected of having Cowden syndrome.

Documentation Requirements

Document the indication for testing and results.

Specialty Considerations

Genetic specialists should ensure comprehensive family history is included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of diagnoses and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of diagnoses and facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of diagnoses and facilitating better patient management.

Resources

Clinical References

  • •
    National Organization for Rare Disorders (NORD)

Coding & Billing References

  • •
    National Organization for Rare Disorders (NORD)

Frequently Asked Questions

What is the significance of coding Q85.82?

Coding Q85.82 is crucial for identifying patients with Other Cowden syndrome, ensuring they receive appropriate surveillance for associated malignancies and management of congenital anomalies.