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v1.0.0
ICD-10 Guide
ICD-10 CodesQ91.4

Q91.4

Billable

Trisomy 13, nonmosaicism (meiotic nondisjunction)

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

Code Description

ICD-10 Q91.4 is a billable code used to indicate a diagnosis of trisomy 13, nonmosaicism (meiotic nondisjunction).

Key Diagnostic Point:

Trisomy 13, also known as Patau syndrome, is a chromosomal abnormality characterized by the presence of an extra 13th chromosome due to meiotic nondisjunction. This condition leads to severe developmental and physical abnormalities. Infants with Trisomy 13 often present with multiple congenital malformations, including holoprosencephaly, cleft lip and/or palate, polydactyly, and cardiac defects. The severity of the condition varies, but many affected infants have a significantly reduced life expectancy, often not surviving beyond the first year of life. Diagnosis is typically made through karyotyping, which reveals the presence of three copies of chromosome 13. Clinical management focuses on supportive care and addressing specific congenital anomalies. Genetic counseling is essential for families, as the recurrence risk for future pregnancies may be influenced by maternal age and other factors.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of genetic terminology and chromosomal mapping.
  • Differentiation from other trisomies and congenital conditions.
  • Need for precise documentation of associated congenital anomalies.
  • Potential for multiple co-morbidities complicating coding.

Audit Risk Factors

  • Inadequate documentation of associated congenital anomalies.
  • Misclassification of the type of trisomy (mosaic vs. nonmosaic).
  • Failure to capture the severity of the condition.
  • Inconsistent coding of related procedures and diagnoses.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed records of physical examinations, developmental assessments, and any surgical interventions.

Common Clinical Scenarios

Management of infants with congenital heart defects or feeding difficulties due to cleft lip/palate.

Billing Considerations

Pediatric coders must ensure that all congenital anomalies are documented to support the complexity of care provided.

Genetics

Documentation Requirements

Karyotype results, family history, and genetic counseling notes.

Common Clinical Scenarios

Prenatal diagnosis and postnatal genetic counseling for families with a history of chromosomal abnormalities.

Billing Considerations

Genetic coders should focus on the implications of the diagnosis for future pregnancies and the need for comprehensive genetic counseling.

Coding Guidelines

Inclusion Criteria

Use Q91.4 When
  • Follow the official ICD
  • CM coding guidelines for congenital malformations and chromosomal abnormalities, ensuring accurate documentation of all associated conditions and anomalies

Exclusion Criteria

Do NOT use Q91.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

81228CPT Code

Chromosomal analysis, karyotype

Clinical Scenario

Used for confirming diagnosis of Trisomy 13.

Documentation Requirements

Karyotype report and clinical indication for testing.

Specialty Considerations

Genetic specialists must ensure accurate interpretation of results.

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 data collection and reimbursement for complex cases like Trisomy 13.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of data collection and reimbursement for complex cases like Trisomy 13.

Reimbursement & Billing Impact

reimbursement for complex cases like Trisomy 13.

Resources

Clinical References

  • •
    National Down Syndrome Society
  • •
    Genetics Home Reference

Coding & Billing References

  • •
    National Down Syndrome Society
  • •
    Genetics Home Reference

Frequently Asked Questions

What is the prognosis for infants with Trisomy 13?

Infants with Trisomy 13 often face severe health challenges and have a high mortality rate, with many not surviving beyond the first year. Supportive care and management of specific anomalies are crucial.