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v1.0.0
ICD-10 Guide
ICD-10 CodesQ91.7

Q91.7

Billable

Trisomy 13, unspecified

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

Code Description

ICD-10 Q91.7 is a billable code used to indicate a diagnosis of trisomy 13, unspecified.

Key Diagnostic Point:

Trisomy 13, also known as Patau syndrome, is a chromosomal disorder caused by the presence of an extra 13th chromosome. This condition is characterized by severe intellectual disability and multiple congenital anomalies. Common physical features include cleft lip and/or palate, polydactyly, and heart defects. Infants with Trisomy 13 often present with microcephaly, holoprosencephaly (failure of the brain to properly divide into two hemispheres), and other neurological deficits. The prognosis for children with Trisomy 13 is generally poor, with many affected individuals not surviving past the first year of life. Diagnosis is typically made through karyotyping, which reveals the presence of an extra chromosome 13. Management of Trisomy 13 is supportive, focusing on the treatment of associated congenital anomalies and providing palliative care as needed.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variability in presentation and severity of symptoms
  • Need for genetic testing documentation
  • Differentiation from other chromosomal abnormalities
  • Potential for multiple coexisting congenital conditions

Audit Risk Factors

  • Inadequate documentation of genetic testing results
  • Failure to document associated congenital anomalies
  • Misclassification of severity or type of Trisomy 13
  • Inconsistent coding of related conditions

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed clinical notes on physical examination findings, developmental milestones, and management plans.

Common Clinical Scenarios

Management of infants with Trisomy 13 in the NICU, including feeding difficulties and respiratory support.

Billing Considerations

Pediatric coders must ensure that all congenital anomalies are documented and coded accurately to reflect the complexity of care.

Genetics

Documentation Requirements

Comprehensive genetic counseling notes, including family history and results of chromosomal analysis.

Common Clinical Scenarios

Genetic counseling sessions for families with a diagnosis of Trisomy 13, discussing implications and management options.

Billing Considerations

Genetic coders should focus on the accuracy of genetic testing documentation and the implications for family planning.

Coding Guidelines

Inclusion Criteria

Use Q91.7 When
  • Coders should refer to the official ICD
  • CM guidelines for congenital malformations and chromosomal abnormalities, ensuring that all relevant clinical information is captured and that the code reflects the patient's specific condition

Exclusion Criteria

Do NOT use Q91.7 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

81228CPT Code

Chromosomal analysis, karyotype

Clinical Scenario

Used to confirm diagnosis of Trisomy 13 through genetic testing.

Documentation Requirements

Documentation of the reason for testing and results.

Specialty Considerations

Genetic specialists must ensure accurate coding of tests performed.

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 cases like Trisomy 13. This specificity aids in better resource allocation and management planning.

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 cases like Trisomy 13. This specificity aids in better resource allocation and management planning.

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 cases like Trisomy 13. This specificity aids in better resource allocation and management planning.

Resources

Clinical References

  • •
    CDC - Trisomy 13 (Patau Syndrome)

Coding & Billing References

  • •
    CDC - Trisomy 13 (Patau Syndrome)

Frequently Asked Questions

What is the prognosis for children with Trisomy 13?

The prognosis for children with Trisomy 13 is generally poor, with many not surviving past the first year of life due to severe congenital anomalies and associated health complications.