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ICD-10 Guide
ICD-10 CodesQ92.5

Q92.5

Billable

Duplications with other complex rearrangements

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

Code Description

ICD-10 Q92.5 is a billable code used to indicate a diagnosis of duplications with other complex rearrangements.

Key Diagnostic Point:

Q92.5 refers to chromosomal abnormalities characterized by duplications that occur alongside other complex rearrangements of chromosomal material. These abnormalities can lead to a variety of clinical manifestations, including developmental delays, congenital malformations, and increased risk for other genetic disorders. The duplications may involve segments of chromosomes that can disrupt normal gene function, leading to phenotypic variations. Patients may present with a range of symptoms depending on the specific genes affected and the extent of the chromosomal rearrangement. Diagnosis typically involves karyotyping or chromosomal microarray analysis, which can identify the presence of duplications and other structural abnormalities. Management of these conditions often requires a multidisciplinary approach, including genetic counseling, developmental assessments, and tailored interventions to address the specific needs of the child.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variability in clinical presentation and severity of symptoms
  • Need for precise genetic testing and interpretation of results
  • Potential for multiple concurrent chromosomal abnormalities
  • Complexity in distinguishing between similar codes

Audit Risk Factors

  • Inadequate documentation of genetic testing results
  • Misclassification of chromosomal abnormalities
  • Failure to capture all relevant clinical manifestations
  • Inconsistent coding practices across different providers

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Pediatric documentation should include detailed developmental assessments, family history, and any associated congenital anomalies.

Common Clinical Scenarios

Common scenarios include referrals for developmental delays, congenital heart defects, or other physical anomalies linked to chromosomal abnormalities.

Billing Considerations

Consideration must be given to the age of the child and the timing of interventions, as early diagnosis can significantly impact outcomes.

Genetics

Documentation Requirements

Genetic documentation must include results from chromosomal analysis, family pedigree, and any genetic counseling notes.

Common Clinical Scenarios

Scenarios often involve prenatal genetic testing, postnatal evaluations of newborns with suspected genetic syndromes, and follow-up for known chromosomal abnormalities.

Billing Considerations

Genetic coders must be aware of the nuances in genetic terminology and the implications of specific chromosomal changes.

Coding Guidelines

Inclusion Criteria

Use Q92.5 When
  • Official coding guidelines for congenital and chromosomal conditions emphasize the importance of accurate documentation of the chromosomal analysis and the clinical context in which the diagnosis is made

Exclusion Criteria

Do NOT use Q92.5 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

81228CPT Code

Chromosomal microarray analysis

Clinical Scenario

Used to identify duplications and complex rearrangements in patients with developmental delays.

Documentation Requirements

Documentation must include the reason for testing and the clinical findings leading to the genetic evaluation.

Specialty Considerations

Geneticists should ensure that the testing aligns with clinical indications and that results are communicated effectively.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of chromosomal abnormalities, improving the accuracy of data collection and reimbursement processes for genetic testing and related services.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of chromosomal abnormalities, improving the accuracy of data collection and reimbursement processes for genetic testing and related services.

Reimbursement & Billing Impact

reimbursement processes for genetic testing and related services.

Resources

Clinical References

  • •
    Genetics Home Reference
  • •
    American Academy of Pediatrics

Coding & Billing References

  • •
    Genetics Home Reference
  • •
    American Academy of Pediatrics

Frequently Asked Questions

What are the implications of coding Q92.5?

Coding Q92.5 indicates a complex chromosomal abnormality that may require multidisciplinary management. Accurate coding is essential for appropriate care planning and reimbursement.

How can I ensure accurate documentation for Q92.5?

Ensure that all genetic testing results, clinical findings, and developmental assessments are thoroughly documented to support the diagnosis and coding.