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v1.0.0
ICD-10 Guide
ICD-10 CodesQ87.85

Q87.85

Billable

MED13L syndrome

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

Code Description

ICD-10 Q87.85 is a billable code used to indicate a diagnosis of med13l syndrome.

Key Diagnostic Point:

MED13L syndrome is a rare genetic disorder characterized by a range of congenital malformations and developmental delays. It is caused by mutations in the MED13L gene, which plays a crucial role in the regulation of gene expression during embryonic development. Patients with MED13L syndrome often present with distinctive facial features, including a broad forehead, downturned corners of the mouth, and a prominent chin. Congenital malformations associated with this syndrome may include cardiac defects, skeletal abnormalities, and issues with the skin, such as congenital nevi or other skin lesions. Additionally, patients may exhibit abnormalities in the breast, spleen, and adrenal glands, leading to further complications. The severity and combination of these malformations can vary significantly among affected individuals, necessitating a multidisciplinary approach to management and care. Early diagnosis and intervention are critical for improving outcomes and addressing the various health challenges associated with this syndrome.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation of congenital malformations
  • Need for genetic testing and interpretation of results
  • Potential for multiple coexisting congenital conditions
  • Documentation of developmental milestones and delays

Audit Risk Factors

  • Inadequate documentation of genetic testing results
  • Failure to capture all associated congenital malformations
  • Misinterpretation of developmental delays
  • Lack of interdisciplinary notes in patient records

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed records of growth and development, including milestones and any observed congenital anomalies.

Common Clinical Scenarios

Assessment of a newborn with multiple congenital anomalies, follow-up visits for developmental delays.

Billing Considerations

Ensure accurate coding of all congenital conditions and associated complications, as well as ongoing developmental assessments.

Genetics

Documentation Requirements

Comprehensive genetic testing results, family history, and detailed descriptions of phenotypic features.

Common Clinical Scenarios

Genetic counseling sessions for families with a history of congenital anomalies, diagnosis confirmation through genetic testing.

Billing Considerations

Consider the implications of genetic findings on family planning and the need for potential referrals to specialists.

Coding Guidelines

Inclusion Criteria

Use Q87.85 When
  • Follow the official ICD
  • CM guidelines for coding congenital conditions, ensuring that all relevant congenital anomalies are documented and coded accurately
  • Use additional codes to capture associated conditions as necessary

Exclusion Criteria

Do NOT use Q87.85 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

81228CPT Code

Genetic testing for MED13L mutations

Clinical Scenario

Used in the diagnosis of MED13L syndrome.

Documentation Requirements

Documentation of clinical indications for genetic testing.

Specialty Considerations

Geneticists 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 ability to capture the complexity of syndromes like MED13L syndrome and associated anomalies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the ability to capture the complexity of syndromes like MED13L syndrome and associated anomalies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the ability to capture the complexity of syndromes like MED13L syndrome and associated anomalies.

Resources

Clinical References

  • •
    National Organization for Rare Disorders (NORD)

Coding & Billing References

  • •
    National Organization for Rare Disorders (NORD)

Frequently Asked Questions

What are the common congenital anomalies associated with MED13L syndrome?

Common anomalies include congenital heart defects, skeletal abnormalities, and skin lesions. Each patient may present with a unique combination of these features.