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v1.0.0
ICD-10 Guide
ICD-10 CodesQ56.0

Q56.0

Billable

Hermaphroditism, not elsewhere classified

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

Code Description

ICD-10 Q56.0 is a billable code used to indicate a diagnosis of hermaphroditism, not elsewhere classified.

Key Diagnostic Point:

Hermaphroditism refers to a condition where an individual possesses both male and female reproductive organs or characteristics. This congenital condition can manifest in various forms, including ambiguous genitalia, where the external genitalia do not clearly resemble either male or female anatomy. In some cases, individuals may present with hypospadias, a condition where the urethral opening is located on the underside of the penis, or cryptorchidism, where one or both testes fail to descend into the scrotum. Uterine malformations may also be present, affecting the reproductive capabilities of individuals assigned female at birth. The diagnosis of hermaphroditism often involves a multidisciplinary approach, including genetic testing to identify chromosomal abnormalities that may contribute to the condition. Accurate coding is essential for appropriate management and treatment planning, as well as for understanding the underlying genetic factors that may influence the presentation of these congenital malformations.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variability in presentation of genitalia
  • Need for genetic testing and interpretation
  • Differential diagnosis with other conditions
  • Multidisciplinary care requirements

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Misclassification of ambiguous genitalia
  • Failure to include genetic testing results
  • Inconsistent coding across different healthcare providers

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed physical examination findings, including descriptions of genitalia and any associated anomalies.

Common Clinical Scenarios

Evaluation of newborns with ambiguous genitalia, management of hypospadias or cryptorchidism in infants.

Billing Considerations

Consideration of psychosocial aspects and parental counseling regarding the child's condition.

Genetics

Documentation Requirements

Genetic testing results, family history of congenital conditions, and any chromosomal analysis performed.

Common Clinical Scenarios

Genetic counseling for families with a history of intersex conditions, interpretation of karyotype results.

Billing Considerations

Understanding the implications of genetic findings on treatment and management options.

Coding Guidelines

Inclusion Criteria

Use Q56.0 When
  • Follow the ICD
  • CM coding guidelines for congenital conditions, ensuring accurate documentation of the patient's clinical presentation and any associated anomalies
  • Use additional codes as necessary to capture related conditions

Exclusion Criteria

Do NOT use Q56.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

54660CPT Code

Orchidopexy

Clinical Scenario

Used for surgical correction of cryptorchidism in affected individuals.

Documentation Requirements

Pre-operative assessment, surgical notes, and post-operative follow-up.

Specialty Considerations

Pediatric urology may be involved in the surgical management.

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 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 data collection 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 data collection and facilitating better patient management.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Guidelines for Coding Congenital Conditions

Coding & Billing References

  • •
    American Academy of Pediatrics - Guidelines for Coding Congenital Conditions

Frequently Asked Questions

What documentation is necessary for coding Q56.0?

Comprehensive documentation should include physical examination findings, genetic testing results, and any associated conditions. It is crucial to clearly describe the patient's genitalia and any anomalies present.